Bali Journal of Anesthesiology
Vol 2, No 3 (2018)

POSITIONING OF FRACTURE FEMUR PATIENTS FOR SPINAL ANAESTHESIA: FEMORAL NERVE BLOCK OR INTRAVENOUS FENTANYL?

Kumar, Amarjeet (Unknown)
Sinha, Chandni (Unknown)
Kumar, Ajeet (Unknown)
Kumari, Poonam (Unknown)
Bhadani, Umesh Kumar (Unknown)
Bhar, Ditipriya (Unknown)



Article Info

Publish Date
30 Dec 2018

Abstract

Background: Fracture of the femur is a common, but extremely painful bone injury. Anaesthesiologists face the common problem of improper positioning of the patient while giving sitting spinal due to their extreme pain.Methods: After Institutional Ethical Committee (IEC) clearance, 60 of American Society of Anaesthesiologists (ASA) I/II patients age 18 to 80 years with fracture femur were recruited. Patients in Femoral Nerve Block (FNB) group received ultrasound-guided FNB was given with 15 mL of 1% lignocaine after visualizing the femoral nerve. Patients in the fentanyl group received injection fentanyl 1μg/kg IV. The target was to reduce the Visual Analog Scale (VAS) score less than 4. If despite the intervention, VAS was more than 4, a repeat fentanyl dose (0.5μg/kg) was given.Results: Mean VAS during positioning was 1.57 in FNB versus 2.93 in the fentanyl group (p<0.001). An additional dose of fentanyl required was less in FNB group and was more in fentanyl group (p<0.001). Performer rated quality of patient position was more in FNB group (mean±SD) 2.73 + 0.450 while1.47 + .507 in fentanyl group. This difference was statistically more significant (p<0.001). Patients satisfaction was more in the FNB group than fentanyl group (p<0.001) which was highly significant.Conclusion: Ultrasound-guided FNB provides better analgesia, patient satisfaction, less time for anesthesia and satisfactory positioning than IV fentanyl for a central neuraxial block in patients undergoing surgeries for femur fractures.

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