Indian Journal of Clinical Anaesthesia


A randomized prospective study of comparison of IV Fentanyl vs. femoral nerve block to facilitate administration of subarachnoid block in sitting position for femur fracture surgeries


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Author Details: P Vandana Pakhare, Pradeep Pendyala

Volume : 3

Issue : 4

Online ISSN : 2394-4994

Print ISSN : 2394-4781

Article First Page : 507

Article End Page : 511


Abstract

Background: Providing adequate pain relief not only gives comfort to the patients, but also shown to improve positioning for neuraxial block. Analgesics or femoral nerve block (FNB) are often used to help the patient tolerate pain while positioning for neuraxial block. Femoral nerve block has been shown to be an effective method of analgesia for fractured femoral shaft when it is performed either during pre-hospital management or in the emergency department.
Objective: To compare the analgesic efficacy of femoral nerve block and IV Fentanyl in femur shaft fracture patients for positioning them for neuraxial block.
Methods: An observational study was conducted among 60 patients belonging to ASA grade I and ASA grade II status undergoing surgery for fracture femur. Patients were randomly allocated to either of the two groups with the help of computerized randomization into: Group A: Femoral Nerve Block and Group B: IV Fentanyl. Data was collected by measuring hemodynamic parameters, VAS score at rest and at movement prior to intervention i.e. femoral nerve block or IV Fentanyl, and every 5 min till 30 min after intervention. The investigator was same for all the cases of the study. Data was analyzed using ANOVA test (Windostat Version 8.6 from indostat services, Hyderabad).
Results: Both femoral nerve block and IV Fentanyl provided analgesia. The hemodynamic parameter variations (H.R., SBP, DBP, and MAP) in Fentanyl and femoral nerve block groups were statistically significant after 10 min interval. It was found that in femoral nerve block group no rescue analgesia was required and in IV Fentanyl group 100% rescue analgesia was required.
Conclusion: Femoral nerve block has better analgesic efficacy compared to IV Fentanyl. Hemodynamic parameters are more stable when femoral nerve block was used for analgesia.

Keywords:
Femoral nerve block, Efficacy, Fentanyl, Analgesia, Intervention