الفهرس | Only 14 pages are availabe for public view |
Abstract Summary When a noxious stimulus produces tissue injury,chemical mediators are released and activate nocieptors which in turn generate nerve impulses. Uncontrolled postoperative pain has an adverse sequel of delayed resumption of normal pulmonary function, restriction of mobility, nausea and vomiting, increase in the systemic vascular resistance, cardiac work, and myocardial oxygen consumption through an increase in the catecholamine release induced by the stress response. Surgeries of the femur and knee are associated with moderate to severe postoperative pain, so these procedures are better to be done under regional anaesthesia techniques which reduce neuroendocrinal stress responses, central sensitization of the nervous system and muscle spasms which occur in response to painful stimuli. Recently, among these regional anaesthesia techniques on the lower limb, approaches to femoral nerve blockade are gaining popularity because they reduce the possibility of complications and side effects associated with the central blocks. Fascia iliaca block provides effective analgesia and anaesthesia with potentially fewer complications and side effects than central blocks. The purpose of this study was to compare between epidural anaesthesia and continuous fascia iliaca block in adult patients undergoing fixation of fractured neck femur or knee arthroplasty including comparison of analgesic efficacy, sideeffects, and complications. The study was performed upon 60 patients, aging 20-60 years, and randomly distributed among two groups: Group A: 30 patients received lumbar epidural anaesthesia. Group B: 30 patients received continuous Fascia iliaca block. For each patient, the following data were collected: age, sex, body weight, duration of surgery, hemodynamic changes, incidence of postoperative complications, and patient satisfaction. The results showed that performing continuous fascia iliaca block provided effective, unilateral analgesia, with fewer complications in comparison to epidural anaesthesia such as hypotension, and postoperative vomiting and urinary retention |