TO COMPARE THE EFFICACY OF FEMORAL NERVE BLOCK vs IV FENTANYL FOR POSITIONING OF SUBARACHNOID BLOCK DURING FEMUR FRACTURE SURGERY

Introduction: Most dreaded fear associated with any fracture is pain which has got wide psychological, behavioral, and clinical ramifications. Aims and Objectives: To compare the efficacy of femoral nerve block with iv fentanyl for positioning of patient during subarachnoid block in femur fracture surgery in terms of time of onset of analgesia (VAS score upto 4), pain score during positioning and quality of patient's position. Material and Methods: The patients in FNB GROUP (n=35) were given femoral nerve block with nerve stimulator by injecting 30 ml of levobupivacaine (a mixture of 20 ml of 0.5% levobupivacaine and 10 ml of normal saline).In FENT GROUP (n=35),IV fentanyl 1 ug/kg five-minute prior to positioning was given,escalating the dose to 3 µg/kg maximum until pain score decreased to ≤4. Results: The results showed that the heart rate, SpO2, blood pressure and respiratory rate were maintained and comparable in both the groups. Time of onset of analgesia and pain scores during positioning were less in FNB group. Time of onset of analgesia VAS 4 was achieved at 15 min in group FNB(4.29±0.57) and at 20 min in group FENT(4.69±0.58).The pain scores achieved during positioning was 1.54±0.50 in group FNB and in group FENT it was 3.77±0.59. Quality of patient's position was better in FNB group. Conclusion: We found that both femoral nerve block and IV fentanyl provide good analgesia during positioning in patients with fracture femur. But femoral nerve block provides better analgesia, early onset of analgesia, more optimal positioning and providing more comfort to patients post-operatively as less analgesics required than IV fentanyl group.