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Fractured femurs. Fascia iliaca compartment blocks

Nirav Jentilal Kacha, Chetna A Jadeja, Pooja J Patel, Harshda B Chaudhari, Jatin R Jivani, Vandana S Pithadia
Background: Patient positioning for performing spinal blockade causes severe pain in hip and femur fracture. Adequate pain relief before administrating spinal blockade will increase patient's cooperation. This study was done to assess analgesic effect of fascia iliaca compartment block (FICB) for positioning for spinal anesthesia. Materials and Methods: This was a randomized, double blind, controlled prospective study that included 100 patients of the American Society of Anesthesiologists physical statuses I to III, of either sex, between 30 and 90 years, posted for hip or proximal femoral surgery, with visual analogue scale (VAS) >3 in preoperative period...
March 2018: Indian Journal of Orthopaedics
Mateusz Klukowski, Rafał Kowalczyk, Grzegorz Górniewski, Paweł Łęgosz, Marek Janiak, Janusz Trzebicki
BACKGROUND: Fractures of the proximal femur in elderly patients are a challenge for orthopedics, anesthe-sio-logy and geriatrics. Early mobilization reduces postoperative mortality among these patients. Effective anal-gesia is necessary to achieve this goal. MATERIAL AND METHODS: A retrospective analysis of perioperative medical records of 78. patients undergoing surgical treatment of proximal femur fractures was performed. Group 1 (n=35)consisted of patients who were treated with pharmacologic analgesia only (systemic analgesics) and Group 2 (n=43) involved patients who re-ceived a preoperative fascia iliaca compartment block (FICB) and pharmacologic analgesia...
October 31, 2017: Ortopedia, Traumatologia, Rehabilitacja
S Ranjit, B B Pradhan
Background Positioning patients with fractured femur for subarachnoid block is painful. Intravenous analgesics or peripheral nerve block like femoral nerve block or fascia iliaca compartment block are some of the available techniques to reduce pain. We compared the efficacy of femoral nerve block and intravenous fentanyl in providing effective analgesia before positioning for subarachnoid block. Objective This study was designed to compare between ultrasound guided femoral nerve block with lignocaine and intravenous fentanyl in providing effective analgesia before positioning patient with femur fracture in sitting position for subarachnoid block...
April 2016: Kathmandu University Medical Journal (KUMJ)
Peter M Odor, Irina Chis Ster, Iain Wilkinson, Frederic Sage
BACKGROUND: Post-operative cognitive impairment is common in elderly patients following surgery for hip fracture, with undertreated pain being an important etiological factor. Non-opioid based analgesic techniques, such as nerve blocks, may help reduce the risk of cognitive complications. The aim of this study was to investigate whether receiving a fascia iliaca compartment block (FICB) as part of a pre-operative analgesic regime increased the odds of high post-operative abbreviated mental test scores (AMTS) when compared with conventional analgesia without a nerve block...
January 5, 2017: BMC Anesthesiology
Rajashree Madabushi, Geetha C Rajappa, Prathima P Thammanna, Sadasivan S Iyer
STUDY OBJECTIVE: Pain arising from femur fractures is of severe nature. Surgery for fixation of femoral fractures may be done under spinal anesthesia. We conducted this study to compare the analgesic efficacy of fascia iliaca compartment block (FICB) and intravenous fentanyl (IVF) before positioning for spinal anesthesia. DESIGN: Randomized controlled trial. SETTING: Operating room. PATIENTS AND INTERVENTIONS: Sixty patients aged 25 to 75 years, with American Society of Anesthesiologists status I to III, undergoing surgery for femur fracture were chosen for the study and randomized into 2 groups...
December 2016: Journal of Clinical Anesthesia
Seunguk Bang, Jihyun Chung, Jaejung Jeong, Hahyeon Bak, Dongju Kim
BACKGROUND: The fascia iliaca compartment block (FICB) provides an analgesic effect in patients with femur fractures. However, the postoperative pain after hip surgery is different from that after femur fracture, because of the difference in the degree and location of tissue trauma. Whether FICB provides effective postoperative analgesia in patients undergoing total hip arthroplasty is not well understood. Moreover, there is no prospective randomized study to evaluate FICB as a postoperative analgesia in hemiarthroplasty...
September 2016: Medicine (Baltimore)
George W Miller, Jenna J Godrey, Markus L Sagmeister, Thomas L Lewis
AIMS: Fascia iliaca compartment block (FICB) is a simple regional anaesthetic block that has been shown to be superior to other regional anaesthetic blocks with regards to success rate and analgesic efficacy in the acute management of proximal femoral fractures. The objective was to quantitatively assess the provision of FICB for patients with proximal femoral fractures in the UK. METHODS: A national observational study of all acute medical trusts in the UK (n=187) was conducted...
November 2016: Injury
Paul Watson, Szabolcs Rugonfalvi-Kiss
Fractured neck of femur (NOF) causes significant morbidity and pain for patients; adequate analgesia is an essential component of patient centred care. Patients experiencing greater pain during treatment for fractured NOF are slower to mobilise and have poorer health-related quality of life. NICE guidance suggests considering adding nerve blocks if paracetamol and opioids do not provide sufficient preoperative pain relief. We set out to audit pain levels in this group of patients in a small District General Hospital and to develop a protocol to improve analgesia provision if required...
2016: BMJ Quality Improvement Reports
Paul J McRae, Jason C Bendall, Veronica Madigan, Paul M Middleton
BACKGROUND: Femoral (thigh) fractures are an important clinical problem commonly encountered by paramedics. These injuries are painful, and the need for extrication and transport adds complexity to the management of this condition. Whereas traditional analgesia involves parenteral opioids, regional nerve blockade for femoral fractures have been demonstrated to be effective when performed by physicians. Regional peripheral nerve blockade performed by paramedics may be suitable in the prehospital setting...
May 2015: Journal of Emergency Medicine
Paul Reavley, Alan A Montgomery, Jason E Smith, Simon Binks, Judith Edwards, Georgina Elder, Jonathan Benger
INTRODUCTION: Femoral neck fractures are a common and painful injury. Femoral nerve blocks, and a variant of this technique termed the '3-in-1' block, are often used in this patient group, but their effect is variable. The fascia iliaca compartment block (FIB) has been proposed as an alternative, but the relative effectiveness of the two techniques in the early stages of care is unknown. We therefore compared the FIB versus the 3-in-1 block in a randomised trial conducted in two UK emergency departments...
September 2015: Emergency Medicine Journal: EMJ
Suresh Kumar N, Kiran N, Ravi M, Don Sebastian, Punith Gowda Rm
BACKGROUND: Patients with fracture femur experience severe pain on movement during positioning for spinal anaesthesia. Fascia Iliaca Compartment Block (FICB) has been used effectively for providing analgesia during positioning of the patient for spinal anaesthesia. AIM: To test the hypothesis that, adding dexamethasone would significantly prolong the duration of Bupivacaine in FICB. MATERIALS AND METHODS: Sixty patients aged 18 to 80 years posted for ORIF (Open Reduction and Internal Fixation) of fracture femur were included to receive FICB...
August 2014: Journal of Clinical and Diagnostic Research: JCDR
Tara L Neubrand, Kelley Roswell, Sara Deakyne, Kendra Kocher, Joseph Wathen
OBJECTIVE: To compare management of acute femur fractures in children who received a fascia iliaca compartment nerve block (FICNB) to those who received systemic intravenously administered analgesics in the pediatric emergency department. The comparison evaluated frequency of use, effectiveness, and associated adverse event profiles. METHODS: Study population was derived from a retrospective chart review of pediatric patients sustaining acute femur fractures between 2005 and 2009...
July 2014: Pediatric Emergency Care
Els Dochez, Geert J van Geffen, Jörgen Bruhn, Nico Hoogerwerf, Harm van de Pas, Gertjan Scheffer
INTRODUCTION: Patients with a proximal femur fracture are often difficult to evacuate from the accident scene. Prehospital pain management for this vulnerable group of patients may be challenging. Multiple co-morbidities, polypharmacy and increased age may limit the choice of suitable analgesics. The fascia iliaca compartment (FIC) block may be an alternative to intravenous analgesics. However this peripheral nerve block is mainly applied by physicians.In the Netherlands, prehospital emergency care is mostly provided by EMS-nurses...
June 23, 2014: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Karen J L Black, Catherine A Bevan, Nancy G Murphy, Jason J Howard
BACKGROUND: Children and adolescents with femoral fractures are almost always admitted to hospital. They invariably start their hospital experience in the Emergency Department, often requiring transfer to a specialist children's hospital. They require analgesia or anaesthesia so that radiographs can be obtained and for management of their fractures. The initial care process involves from two to six transfers from stretcher to stretcher/imaging/operating-suite table or hospital bed within the first few hours, so prompt pain relief is essential...
December 17, 2013: Cochrane Database of Systematic Reviews
B Newman, L McCarthy, P W Thomas, P May, M Layzell, K Horn
We undertook a randomised, controlled trial to compare the analgesic efficacy and opioid sparing effect of nerve stimulator-guided femoral nerve block with fascia iliaca compartment block in patients awaiting surgery for fractured neck of femur. Ten-centimetre visual analogue pain scores were measured before and 2 h after the block and opioid consumption was recorded in the 12-h period after the block. One hundred and ten patients were randomly assigned. Femoral nerve block provided superior pre-operative analgesia for fractured neck of femur compared with fascia iliaca compartment block...
September 2013: Anaesthesia
Samer Elkhodair, Jamal Mortazavi, Adam Chester, Mathew Pereira
OBJECTIVES: Fractured neck of femur (NOF) is a common injury in the elderly, which causes severe pain and distress. Fascia iliaca compartment block using the 'Two Pop Technique' is safe and relatively easy to perform. It has been traditionally performed by anaesthetists in a controlled environment for perioperative pain relief with very good results. The purpose of the study was to investigate its applicability and success rate in a busy emergency department (ED) with changing junior staff and time pressures...
December 2011: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
Joe E Wathen, Dexiang Gao, Glenn Merritt, Gaia Georgopoulos, F Keith Battan
STUDY OBJECTIVE: We determine whether a fascia iliaca compartment nerve block can provide superior pain management compared with intravenous morphine sulfate for the initial pain management of femur fracture patients presenting to a pediatric emergency department. The primary outcome measured is pain scores; a difference of 15% in scores assessed at 30 minutes from the study's baseline pain management is considered clinically meaningful. Secondary outcomes include the duration of analgesia, the need for additional medications, adverse events, nerve block complications, and satisfaction scores...
August 2007: Annals of Emergency Medicine
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