الفهرس | Only 14 pages are availabe for public view |
Abstract F racture of the femur is a well-known reason for surgical repair in patients of all ages. Locations include the neck, intertrochanteric, shaft, and distal fractures. Spinal anesthesia is the commonly used, preferred method for surgery and is associated with lower odds of mortality compared to general anesthesia. Spinal anesthesia is administered in either a sitting or lateral decubitus position. Positioning patients with a fractured femur for spinal anesthesia is challenging since minimal movement of the overriding fracture ends can cause extreme pain. FICB is seen as a simple safe method which is easy to learn and use. FICB is also well described for acute pain management of femur fractures and was shown to decrease opioid requirements. In addition, adequate pain control in these patients not only decreases the discomfort but was also shown to improve positioning for spinal anesthesia. Correct positioning during spinal anesthesia is also crucial for a successful procedure. The aim of this study was to elaborate the efficacy and safety of FICB with intravenous analgesic (IVA) on the quality for positioning before spinal anesthesia in participants with a femur fracture. After approval of anesthesiology department scientific and ethical committees in Ain Shams University Hospitals, patients were included in the study, and were divided into two groups (n=25; each); group FICB and control group • group FICB: Patients (n=25) of this group received ultrasound guided Fascia iliaca compartment block (FICB) before spinal anesthesia using 20-40 ml of 0.25% bupivacaine. • Control Group: Patients (n=25) of this group received IV fentanyl 0.5mic/kg repeated up to maximum of 3 doses. The two groups were adequately monitored and assessed Preprocedural and postprocedural and they were compared regarding analgesic outcome by using the visual analogue scaling system. Demographic data, pre-operative and post-operative hemodynamics were also assessed. |