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

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.
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.
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).
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
  • 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

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research network!

Choose Username:
Verify Password: