EFFECTIVENESS OF FASCIA ILIACA COMPARTMENT BLOCK FOR POST OPERATIVE ANALGESIA AFTER SURGERY FOR FEMUR BONE FRACTURE

Background:Multimodal analgesia is given to alleviate postoperative pain in fracture neckfemur.Present study is done to assess the effectiveness of fascia iliaca compartment block for post operative analgesia after surgery for femur fractures. Aims & Objectives: 1) To study effect on pain at rest and with movement 2) To study duration of post operative analgesia with fascia iliaca compartment block 3) TO study post operative analgesic requirement Methods: Afer approval from institution review board committee, this prospective randomised observational study was conducted at our institute after taking informed consent from each patient. Total 60 adult patients (ASA I/II) aged 18 to 70 years, of either sex undergoing femur bone fracture surgery under subarachnoid block were included. Sub arachnoid block was performed in the sitting posture under strict aseptic precautions in theL2-L3 or L3-L4 space using 23G Quincke needle with 3.5ml of 0.5%Bupivacaine (hyperbaric, dextrose 80mg/ml) in all patients. Patients were randomly divided in two groups, Group A (n=30): The FICNB group was received ultrasound guided fascia iliaca compartment block with 0.25% bupivacaine 30ml at the end of the operation. Group B (n=30): were managed without FICNB Hemodynamic variables like heart rate, non invasive blood pressure, saturation of oxygen, were recorded after the block. The analgesia provided by either of the modes was assessed by using Visual analogue scale scores at 5 mins,10 mins,15 mins,20 mins,25 mins,30 mins,40 mins,50 mins,1, hr,then hourly upto,12 hour,then 2 hourly upto 24 hour. Postoperative hemodynamic monitoring was done and depicated in tabular form. Patients were watched for adverse effects of drugs and complications of procedure itself.The duration of postoperative analgesia was compared between the 2 groups using visual analogue scale and in terms of first rescue analgesic and total analgesic dose requirement with inj. diclofenac sodium75 mg.The data were studied using mean values and mean ± SD and then compared using unpaired ttest. p value <0.05 was considered significance Results:The result obtained in study At 1hr Mean VAS in group A was 2.23 ±0.43 and in group B it was 4.93±0.25 At 7hr Mean VAS in group A was 2.96 ± 0.18 and in group B it was 4.9±0.31 At 12hr Mean VAS in group A was 4.66±0.80 and in group B it was 3.83±0.38 At 14hr Mean VAS in group A was 1.86±1.25 and in group B it was4.93±0.25 Post-operative VAS at rest and moment were significantly higher in group B, compared to group A (p<0.001). After 24 hr statistically significant difference was not observed in mean VAS between group B and group C. The mean consumption of analgesic was 137.5±28.42 mg diclofenac in Group A and 295±19.03 mg diclofenac in group B.