الفهرس 
Introduction
Management of acute painOnly 14 pages are availabe for public view
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Abstract
Positioning of patients with proximal femur fractures is extremely painful so that performance of spinal anesthesia becomes very difficult for both the patient and the anesthetist as well. So multiple modes of analgesia are used to relief pain and allow patients to be properly and easy positioned such as opioids, nonsteroidal anti-inflammatory medications and peripheral nerve blocks ( as FICB and FNB). The aim of this study was to evaluate the efficacy of FICB compared to an analgesic opioid such as intravenous morphine sulfate for positioning of patients with proximal femur fractures before spinal anesthesia in the sitting position. 92 patients who underwent elective proximal femur surgery were allocated into two groups (46 patients in each group): Fascia iliaca compartment block (FICB) group (46 patients) : received 40 ml of bupivacaine 0.25% by ultrasound-guided technique. Intravenous morphine sulfate (IVM) group (46 patients) : received 0.1 mg/kg intravenous morphine sulfate as slow intravenous injection. Vas score and hemodynamic changes were compared between both groups during positioning before and after the intervention (FICB/IVM) and throughout the 24h postoperatively. Quality of positioning, time of performance of SA, time to first rescue analgesia and 24h total analgesic requirement were also compared between both groups. In this study, both FICB and IVM provided improvement regarding pain control and decreased VAS score. However, FICB was found to be of significant higher analgesia with better quality of patient positioning and less time of performance of spinal anesthesia than IVM. Decreased 24h total analgesic requirement and the significant delay in time to first rescue analgesia of FICB group suggested the postoperativ e analgesic effect of FICB that could be beneficial to elderly patients with multiple comorbidities in whom opioids and nonsteroidal anti-inflammatory medications are better to be avoided. In conclusion, the present study demonstrates that ultrasound guided FICB has better pain control than intravenous morphine sulfate for positioning of patients with femur fractures for spinal anesthesia with better quality of position, lesser time of performance of spinal anesthesia, and decreased the total analgesic requirements in the first 24 hours postoperatively.