The Efficacy of Continuous Fascia Iliaca Compartment Block for Pain Management in Burn Patients Undergoing Skin Grafting Procedures

Abstract

Postoperative pain at the split skin donor sites is often more intense than the pain at the grafted site. This prospective, randomized, double-blind study assessed the efficacy of a continuous fascia iliaca compartment block in reducing the pain at the thigh donor site.

Continuous Femoral Nerve Block Versus Fascia Iliaca Compartment Block as Postoperative Analgesia in Patients with Hip Fracture

“…In all studies demonstrating unwanted consecutive side-effects, such as studies by Layzell [16], Beaudoin [19], Foss et al [20] and Cuignet et al [24], there were no recorded side-effects such as haematoma, infection, and paraesthesia which are also the most common adverse consecutive side effects of nerve blocks. In none of these studies was a systemic toxic effect of applied local anaesthetic registered.…”

“…The only study in which the fascia iliaca compartment block was used for postoperative analgesia as a continuous technique is the Cuignet et al [24] study which used the continuous block analgesia in patients with burns and for taking graft from the femoral area. The effect of the block was assessed with the VAS scale particularly preoperatively, 24 and 48 hours post-operatively, and during the first bandage change at 72 hours post-operatively.…”

“…It is performed by application of a great amount of local anaesthetic beneath the fascia iliaca and provides a block of n. femoralis and n. cutaneus femoris lateralis and rarely of n. obturatorius [20,21]. It is a very simple procedure to perform this block; there are almost no complications and hence this procedure belongs to the small group of blocks that need no nerve stimulator or ultrasound [22][23][24]. Although it is simpler in comparison to femoral nerve block, the authors who have experience in performing peripheral block consider it a second choice [25].…”

Acute and Perioperative Care of the Burn-Injured Patient

“…77 Central neuraxial techniques (spinals, epidurals) have been utilized with good effect as both primary anesthetics and postoperative adjuncts in burn injured patients. There are no reports suggesting epidural abscesses are more common in burn patients, but reports have suggested that intravascular catheters are more likely to become infected if placed in or near burned tissue; 78 similarly caution is likely reasonable in selecting appropriate burn patients for central neuraxial techniques.…”

“…Sometimes there is a need to cover the anterior and medial thigh due to the extent of skin harvest, and therefore a fascia iliaca block can also be performed. [76][77][78] …”