Comparative Evaluation of FasciaIliaca Compartment Block and Intravenous Fentanyl for Positioning During Spinal Anesthesia in Fracture Femur Surgeries - A Randomized Controlled Study

Background: Spinal anaesthesia is the commonly used anaesthetic technique for surgery of fracture femur. Severe pain during patient positioning for spinal anaesthesia is a major concern. Opioids and other systemic analgesics have been in use to provide pain relief and improve positioning while the peripheral nerve blocks have now come up as a safe and an effective alternative. Methods: After the hospital ethics committee approval, 60(ASAI?II) adult patients scheduled for Femur fracture surgeries were included in this study. The Group FICB (n=30) received 30ml of 0.25% bupivacaine under landmark technique fifteen minutes before positioning. Group FENT (n=30) received titrated doses of Inj.Fentanyl 0.5mcg/kg I.V. repeated to 3 doses (1.5 mcg/kg totally) with an interval of 5 minutes between doses, the first dose given 15 minutes before positioning. Visual Analogue Scale score, quality of patient positioning, patient satisfaction, time to perform spinal anaesthesia and requirement of first rescue analgesic post op were compared between the two groups. Results: VAS score during positioning in group FICB: 1.59 ? 1.31 versus FENT: 2.80? 1.64 (P=0.0025).Quality of patient positioning in groupFICB: 2.40?0.85versusFENT:1.68?0.60(P=0.0004). Time taken to perform spinal anesthesia in group FICB: 4.86?0.49 Versus FENT: 5.66 ?0.89 (Pless than0.0001). Conclusion: It is concluded that comparing with Intravenous Fentanyl, FICB provides better quality during positioning of femur fracture patients, better quality of patient positioning, greater patient satisfaction.