A COMPARATIVE EVALUATION OF FEMORAL NERVE BLOCK AND INTRAVENOUS FENTANYL FOR POSITIONING DURING SPINAL ANAESTHESIA IN SURGERY OF FEMUR FRACTURE

Background:Femur surgeries are very common surgeriesRegional anaesthesia is common for that.Giving position for it is real task for anaesthetist.This challange can be overcome by giving Femoral nerve block.Ultrasonography guided blocks are getting famous in last 5 years.we have studied USG guided femoral nerve block for positioning for spinal anaesthesia in fracture femur patients. Methods: This study was conducted at tertiary care hospital on 60 elective patients posted for elective femur fracture surgeries, with ASA grade I and II, in age group of 18-70 years. The patients were randomly divided into 2 groups – Group FNB and Group FENT. In FNB group, patients received USG guided FNB 15 minutes prior to positioning with 15 ml, 1.5 % lignocaine with Adrenaline. In FENT group, patients received injection fentanyl 1µg/kg IV 15 minutes prior to positioning for SA.Both the groups were evaluated for Hemodynamic changes, VAS score, Rescue requirements of fentanyl aliquots, Performance time, Patients satisfaction, Anesthetists satisfaction and Perioperative complications. Results :Both the groups were comparable with respect to age, gender, ASA grade, HR and MAP.In our study,Hemodynamic stability was observed in both groups. VAS Score was lesser in Group FNB (0.93±0.87mins) compared to GroupFENT (1.72±1.09 mins) prior to positioning for SA (p value <0.003). Rescue requirement of fentanyl aliquots for positioning It was less in Group FNB (0.06±0.25 mins) compared to Group FENT (0.34±0.61 mins) (p value<0.02 ). Performance time was shorter in Group FNB (15.33±1.27 mins) compared to Group FENT (16.72±3.07 mins) (p value<0.02 ). Patients satisfaction was less in Group FENT as compared to Group FNB. (p value < 0.03). Anesthetists satisfaction was less in Group FENT as compared to Group FNB. (p value < 0.02). Perioperative complications: In FNB group out of 30 patients, 1 patient had shivering. In FENT group out of 30 patients, 2 patients had shivering and 1 patient had hypotension. Conclusion: US guided femoral nerve block is more advantageous than IV fentanyl for position of fracture femur patients.