Dislocation of a Femur Fracture After Femoral Nerve Block

Background: Fracture of the femur is a common orthopaedic problem following trauma in patients of all ages. This study was undertaken to evaluate the effectiveness of femoral nerve block (FNB) in positioning the patients for regional anesthesia.Methods: 100 patients between the ages 18 to 80 years, of ASA grade I, II and III, scheduled for elective surgeries of femur fracture were evaluated in 2 groups. Group FNB (n=50) received femoral nerve block with 15ml of 1.5% lignocaine and Group. Non FNB (n=50) was not given any block. Assessment of pain was carried out using visual analog scale (VAS). This was rated before, during and after the procedure of positioning for spinal/combined spinal epidural anesthesia (CSE). Vital parameters were tabulated.Results: VAS scores were noted at 0, 2, 5,10,15 minutes and at the time of positioning. VAS scores at 15 minutes after FNB was 1.473 ±0.1639 and 8.250±0.3615 in patients without FNB. Time taken for CSE was significantly less in FNB group (13.026±0.4628) minutes as compared to non FNB group (19.660 ±0.3742) minutes. Patient satisfaction scores were significantly higher in FNB group (45/50) 1.4952±0.033 as compared to non FNB group (10/50) 0.3460±0.1786. Quality of patient positioning was better in FNB group (2.782 ±0.1273) as compared to non FNB (1.382±0.2473).Conclusions:This study concludes that FNB is highly effective in giving good pain relief for positioning for regional anaesthetic procedures improving performance time and offers higher acceptance among patients with femoral fractures.

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TO COMPARE THE EFFICACY OF FEMORAL NERVE BLOCK vs IV FENTANYL FOR POSITIONING OF SUBARACHNOID BLOCK DURING FEMUR FRACTURE SURGERY.

Indian Journal of Medical Research and Pharmaceutical Sciences - September-2020 ◽

10.29121/ijmrps.v7.i11.2020.3 ◽

2020 ◽

Vol 7 (11) ◽

pp. 20-26

Keyword(s):

Pain Score ◽

Nerve Block ◽

Femur Fracture ◽

Femoral Nerve Block ◽

Femoral Nerve ◽

Subarachnoid Block ◽

Pain Scores ◽

Group Time ◽

Fracture Surgery

Introduction: Most dreaded fear associated with any fracture is pain which has got wide psychological, behavioral, and clinical ramifications. Aims and Objectives: To compare the efficacy of femoral nerve block with iv fentanyl for positioning of patient during subarachnoid block in femur fracture surgery in terms of time of onset of analgesia (VAS score upto 4), pain score during positioning and quality of patient’s position. Material and Methods: The patients in FNB GROUP (n=35) were given femoral nerve block with nerve stimulator by injecting 30 ml of levobupivacaine (a mixture of 20 ml of 0.5% levobupivacaine and 10 ml of normal saline).In FENT GROUP (n=35),IV fentanyl 1 ug/kg five-minute prior to positioning was given,escalating the dose to 3 µg/kg maximum until pain score decreased to ≤4. Results: The results showed that the heart rate, SpO2, blood pressure and respiratory rate were maintained and comparable in both the groups. Time of onset of analgesia and pain scores during positioning were less in FNB group. Time of onset of analgesia VAS 4 was achieved at 15 min in group FNB(4.29±0.57) and at 20 min in group FENT(4.69±0.58).The pain scores achieved during positioning was 1.54±0.50 in group FNB and in group FENT it was 3.77±0.59. Quality of patient’s position was better in FNB group.

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