Single Fascia Iliaca Compartment Block for Post-Hip Fracture Pain Relief

Monzón, Daniel Godoy; Iserson, Kenneth V.; Vazquez, Jorge A.

doi:10.1016/j.jemermed.2006.08.011

Cited by 86 publications

(82 citation statements)

References 27 publications

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“…Similar findings have been reported by other investigators demonstrating FICB to provide excellent pain relief for positioning for SAB. [6][7][8] One important point to be noted in the present study is that the baseline pain VAS in patients of both the arms is around 3 only, which is lower than what most other investigators have reported. [6][7][8][9] One study has reported low baseline VAS as in our study.…”

Section: Discussioncontrasting

confidence: 76%

“…The mean duration of time between the injury and surgery in the present study is more than 3 days unlike within 24 hours in other studies. [6][7][8][9] Better pain relief and, therefore, better positioning with the FICB is well reflected in the time required for performing the SAB. The time required for performing SAB with FICB was almost half a minute less than that of FNB in the present study.…”

Section: Discussionmentioning

confidence: 99%

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Analgesia before Performing Subarachnoid Block in the Sitting Position in Patients with Proximal Femoral Fracture: A Comparison between Fascia Iliaca Block and Femoral Nerve Block

Ghimire

Bhattarai

Koirala

et al. 2017

Kathmandu Univ. Med. J.

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Background Positioning for subarachnoid block (SAB) in patients with femoral fracture is painful and may remain suboptimal requiring use of large doses of opioids. These patients generally being elderly with multiple comorbidities and frailty are likely to have many undesirable effects of opioids including respiratory depression and confusion.Objective The objective was to compare the feasibility and effectiveness of fascia iliaca compartment block (FICB) and femoral nerve block (FNB) in reducing pain associated with positioning for subarachnoid block in patients undergoing proximal femoral fracture fixation procedures.Method Group FICB patients (n=15) received fascia iliaca block with 30 ml of 1.5% lignocaine with adrenaline and group FNB patients (n=15) received femoral nerve block with 15 ml of 1.5% lignocaine with adrenaline. After the study blocks, patients were kept on supine position for at least 20 minutes before shifting them to the operation theatre. Pain was assessed by using visual analog scale values before the block and during the position for subarachnoid block. Time to perform subarachnoid block, quality of positioning and acceptance was recorded.Result Visual analog scale values during positioning for SAB were lower in FIB group than in FNB (1.0±1.1 versus 2.1±0.8; P<0.05). Time to perform SAB was shorter in FIB than in FNB (109.6±28.2 seconds versus 134.8±31.9 seconds; P<0.05). Quality of patient positioning for SAB was comparable between the groups. Patient acceptance was less in group FNB (P<0.05).Conclusion Fascia iliaca compartment block provides better analgesia than femoral nerve block in terms of facilitating optimal positioning for subarachnoid block in patients undergoing proximal femoral fracture fixation procedure.

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Section: Discussioncontrasting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Analgesia before Performing Subarachnoid Block in the Sitting Position in Patients with Proximal Femoral Fracture: A Comparison between Fascia Iliaca Block and Femoral Nerve Block

Ghimire

Bhattarai

Koirala

et al. 2017

Kathmandu Univ. Med. J.

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“…Multiple studies about the fascia iliaca compartment block have been reported, mostly so far in patients with hip fracture [7][8][9] or with lower limb surgery (i.e. knee ligament reconstruction or femur surgery) [14,15], but also in children [5,[10][11][12][13]16].…”

Section: Discussionmentioning

confidence: 99%

A Randomized and Observer Blinded Comparison of Continuous Femoral Block and Fascia Iliaca Compartment Block in Hip Replacement Surgery

2012

J Anesthe Clinic Res

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IntroductionPain after hip replacement surgery may potentially hinder postoperative physiotherapy and early mobilisation. Regional anesthesia of the lower limb appears to be effective for postoperative pain control [1] in this setting and it has been shown that the lumbar plexus blockade provides high-quality analgesia [2], as the femoral nerve supplies the anterior hip joint capsule, as well as the proximal femur, the quadriceps, iliacus and pectineus muscles.The most common approach is the femoral perivascular technique with a peripheral nerve stimulator [3]. Several studies have demonstrated that this approach does not achieve a reliable block of all three nerves (femoral nerve, obturator nerve, lateral femoral cutaneous (LFC) nerve) [2]. The femoral (FEM) block fails mostly in areas supplied by the LFC and the obturator nerve. Capdevila and Seeberger have seen a sufficient anesthesia of the LFC by using the femoral block in only 62% [2] respectively 44% [4]. But the LFC nerve may at least in part be responsible for pain in the incisional area of hip surgery.An alternative approach to the FEM block is the fascia iliaca compartment (FIC) block. Anesthesia of the LFC is achieved in 90% by using the FIC block [5]. The puncture site is further from the femoral nerve, laterally, and two are perceived when piercing the facia. Local anesthetic does not only reach the LFC nerve, but also the femoral nerve because the needle tip and the femoral nerve are located in the same compartiment (Figure1). Therefore, the FIC block could provide effective analgesia after hip surgery as an alternative to FEM-block.No prospective trial has been reported yet comparing the two approaches in hip surgery in regard to procedural technique differences, analgesia and functional outcome.The goal of the study was to verify the assumption that the FIC block is less time-consuming to perform but provides equally effective analgesia compared to the FEM block, even with an ad hoc implementation in the clinical routine, as performing the fascia iliaca compartment block was a new procedure in our department and experience with it was barely existent compared to the perivascular FEM block. AbstractBackground: Techniques, analgesic effects and functional outcome of continuous femoral nerve and fascia iliaca compartment blocks were compared in patients undergoing hip replacement surgery.

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“…In the absence of available ultrasound machines or nerve stimulators, the fascia iliaca compartment block can be easily performed using a simple blunt needle and local anesthetic. This technique has been successfully used in the emergency department setting [Foss et al, 2007;Monzon et al, 2007;Wathen et al, 2007]. The proceduralist draws a line connecting the pubic bone to the anterior superior iliac spine, and divides this line into thirds.…”

Section: Femur Fracturesmentioning

confidence: 99%

“…At the marking between the distal third (near the anterior superior iliac spine) and middle third, a blunt needle is advanced one centimeter below this point until two pops are felt, the first as the needle punctures the fascia lata and the second as the needle punctures the fascia iliaca. Local anesthetic volumes similar to those used for stimulation-based approaches (20 mL) have been used successfully with the fascia iliaca block with good efficacy [Lopez et al, 2003]; however, weight-based dosing (0.3 mL/kg) [Monzon et al, 2007;Mouzopoulos et al, 2009] and higher doses may be considered to improve local anesthetic delivery [Candal-Couto et al, 2005]. As with any block performed with high volume, confirmation that no intravascular injection has occurred is necessary.…”

Section: Femur Fracturesmentioning

confidence: 99%