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Compartment Block with Ropivacaine Versus Intravenous Fentanyl in Patients with Fracture Femur

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Why is it important?

Introduction: Fracture femur, a painful condition is common in the elderly patients with associated co-morbidities. Systemic NSAIDS increase the chances of epigastric pain, coagulation abnormalities where as opioids increases chances of delirium, altered sensorium, especially in this population [1]. Administration of block to overcome pain avoids the side effects of these analgesics. Proper patient positioning for regional anaesthesia is a challenge for the anaesthesiologists. In this study our aim is to compare perioperative analgesia and ease of patient positioning using fascia iliaca compartment block (FICB) and IV fentanyl. Objective: To compare the efficacy of FICB and IV fentanyl for perioperative analgesia, ease of positioning for spinal anaesthesia in patients with fracture femur, compare haemodynamic parameters. Method: A prospective double blind study was conducted on 60 ASA 1, 2 and 3 patients for 1 years in SRMS IMS, which were divided into 2 groups 30 patients in each group Group 1: Received the Fascia Iliaca compartment block with 20 ml of 0.2% Ropivacaine 15 minutes before the Subarachnoid block. Group 2: Received Intravenous fentanyl at 1 mcg/kg intravenously single dose15 minutes before the Subarachnoid block. VAS score, sitting quality and hemodynamic parameters were noted at regular time interval and were statistically analyzed. Discussion and Conclusion: FICB provides better positioning of the patient for spinal anaesthesia as compared to IV fentanyl and it also prolongs the duration of first postoperative analgesia.

Perspectives

Introduction: Fracture femur, a painful condition is common in the elderly patients with associated co-morbidities. Systemic NSAIDS increase the chances of epigastric pain, coagulation abnormalities where as opioids increases chances of delirium, altered sensorium, especially in this population [1]. Administration of block to overcome pain avoids the side effects of these analgesics. Proper patient positioning for regional anaesthesia is a challenge for the anaesthesiologists. In this study our aim is to compare perioperative analgesia and ease of patient positioning using fascia iliaca compartment block (FICB) and IV fentanyl. Objective: To compare the efficacy of FICB and IV fentanyl for perioperative analgesia, ease of positioning for spinal anaesthesia in patients with fracture femur, compare haemodynamic parameters. Method: A prospective double blind study was conducted on 60 ASA 1, 2 and 3 patients for 1 years in SRMS IMS, which were divided into 2 groups 30 patients in each group Group 1: Received the Fascia Iliaca compartment block with 20 ml of 0.2% Ropivacaine 15 minutes before the Subarachnoid block. Group 2: Received Intravenous fentanyl at 1 mcg/kg intravenously single dose15 minutes before the Subarachnoid block. VAS score, sitting quality and hemodynamic parameters were noted at regular time interval and were statistically analyzed. Discussion and Conclusion: FICB provides better positioning of the patient for spinal anaesthesia as compared to IV fentanyl and it also prolongs the duration of first postoperative analgesia.

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This page is a summary of: Fascia Iliaca Compartment Block with Ropivacaine Versus Intravenous Fentanyl in Patients with Fracture Femur, Indian Journal of Anaesthesia and Analgesia, January 2018, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.5518.12.
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