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Analgesia before a spinal block for femoral neck fracture: fascia iliaca compartment block.

AbstractBACKGROUND:
In this prospective randomized study, the authors compared the analgesic effect of a fascia iliaca compartment (FIC) block with that of intravenous (i.v.) alfentanil when administered to facilitate positioning for spinal anaesthesia in elderly patients undergoing surgery for a femoral neck fracture.
METHODS:
The 40 patients were randomly assigned to one of two groups, namely, the FIC group (fascia iliaca compartment block, n=20) and the IVA group (intravenous analgesia with alfentanil, n=20). Group IVA patients received a bolus dose of i.v. alfentanil 10 microg/kg, followed by a continuous infusion of alfentanil 0.25 microg/kg/min starting 2 min before the spinal block, and group FIC patients received a FIC block with 30 ml of ropivacaine 3.75 mg/ml (112.5 mg) 20 min before the spinal block. Visual analogue pain scale (VAS) scores, time to achieve spinal anaesthesia, quality of patient positioning, and patient acceptance were compared.
RESULTS:
VAS scores during positioning (mean and range) were lower in the FIC group than in the IVA group [2.0 (1-4) vs. 3.5 (2-6), P=0.001], and the mean (+/- SD) time to achieve spinal anaesthesia was shorter in the FIC group (6.9 +/- 2.7 min vs. 10.8 +/- 5.6 min; P=0.009). Patient acceptance (yes/no) was also better in the FIC group (19/1) than in the IVA group (12/8)(P=0.008).
CONCLUSIONS:
An FIC block is more efficacious than i.v. alfentanil in terms of facilitating the lateral position for spinal anaesthesia in elderly patients undergoing surgery for femoral neck fractures.
AuthorsM J Yun, Y H Kim, M K Han, J H Kim, J W Hwang, S H Do
JournalActa anaesthesiologica Scandinavica (Acta Anaesthesiol Scand) Vol. 53 Issue 10 Pg. 1282-7 (Nov 2009) ISSN: 1399-6576 [Electronic] England
PMID19650803 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
Chemical References
  • Analgesics, Opioid
  • Anesthetics, Local
  • Alfentanil
  • Bupivacaine
Topics
  • Aged
  • Aged, 80 and over
  • Alfentanil (administration & dosage)
  • Analgesia (methods)
  • Analgesics, Opioid (administration & dosage)
  • Anesthesia, Spinal (methods)
  • Anesthetics, Local (administration & dosage)
  • Bupivacaine (administration & dosage)
  • Double-Blind Method
  • Fascia
  • Female
  • Femoral Neck Fractures (surgery)
  • Humans
  • Male
  • Middle Aged
  • Nerve Block (methods)
  • Pain Measurement
  • Patient Satisfaction
  • Prospective Studies
  • Treatment Outcome

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