Abstract:
BACKGROUND: Fascia iliaca compartment nerve block (FICNB) has been an established
technique for postoperative analgesia after surgery for femoral bone fracture. FICNB is technically
easy, effective for postoperative pain control after operation for femoral bone fracture and decreases
the complications induced by systemic analgesic drugs. The severity of postoperative pain is affected
by genetics, cultural and social factors across the world. In this study we assessed the efficacy of
fascia iliaca compartment nerve block when it is used as part of multimodal analgesia after surgery
for femoral bone fracture.
METHODS: An institution-based case control study was conducted from September, 2013 to May,
2014. All patients who had been operated on under spinal anesthesia for femoral bone fracture were
included. The patients divided into a FICNB group (n=20) and a control group (n=20). The FICNB group
was given 30 mL of 0.25% bupivacaine at the end of the operation. Postoperative pain was assessed
within the fi rst 24 hours, i.e. at 15 minutes, 2 hours, 6 hours, 12 hours and 24 hours using 100 mm visual
analogue scale (VAS), total analgesic consumption, and the time for the fi rst analgesic request.
RESULTS: VAS pain scores were reduced within the fi rst 24 hours after operation in the FICNB group
compared wtih the control group. VAS scores at 2 hours were taken as median values (IQR) 0.00 (0.00)
vs.18.00 (30.00), P=0.001; at 6 hours 0.00 (0.00) vs. 34.00 (20.75), P=0.000; at 24 hours 12.50 (10.00) vs.
31.50 (20.75), P=0.004; and at 12 hours (17.80±12.45) vs. (29.95±12.40), P=0.004, respectively. The total
analgesic consumption of diclofenac at 12 and 24 hours was reduced in the FICNB group, and the time for
the fi rst analgesic request was signifi cantly prolonged (417.50 vs. 139.25 minutes, P=0.000).
CONCLUSIONS: A single injection for FICNB could lead to postoperative pain relief, reduction
of total analgesic consumption and prolonged time for the fi rst analgesic request in the FICNB group
after surgery for femoral bone fracture. We recommend FICNB for analgesia after surgery for femoral
bone fracture and for patients with femoral bone fracture at the emergency department.
