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VOLUME 3 , ISSUE 2 ( September, 2008 ) > List of Articles

Original Article

Fascia iliaca compartment block performed by junior registrars as a supplement to pre-operative analgesia for patients with hip fracture

Annette Høgh, Lene Dremstrup, Steffen Skov Jensen, Jes Lindholt

Keywords : Fascia iliaca compartment block, Hip fracture, Pre-operative analgesia

Citation Information : Høgh A, Dremstrup L, Jensen SS, Lindholt J. Fascia iliaca compartment block performed by junior registrars as a supplement to pre-operative analgesia for patients with hip fracture. 2008; 3 (2):65-70.

DOI: 10.1007/s11751-008-0037-9

License: CC BY-NC-SA 4.0

Published Online: 01-09-2008

Copyright Statement:  Copyright © 2008; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

This study investigate the efficacy of pre-operative pain treatment for patients with hip fractures using fascia lliaca compartment block (FIB) technique performed by junior registrars (JR) as a supplement to conventional pain treatment. The FIB technique has routinely been used pre-operatively in the emergency department since 1 January 2004 for all patients with hip fractures. Over an 8-month period, 187 patients were treated. FIB was performed with 40 ml lidocaine and bubivacaine. A simple 5-step verbal pain score and maximal passive hip flexion was used as objective and subjective pain measurements. Effect of FIB was prospectively assessed on 70 patients: 2/3 females, mean age 80.7 (SD = 7.8), 36% in ASA-group III and IV (95% CI, 0.25–0.48). The median pain-free hip flexion pre-block was 15° (SD = 17) this improved to a median of 28° (SD = 21) 15 min post-block (P = 0.014) and 37° (SD = 26) 60 min post-block (P = 0.030). The median simple verbal pain score (0–4) pre-block was 2.2 (SD = 0.92). This decreased to a median of 1.5 (SD = 0.78) 15 min post-block (P < 0.001) and 1.3 (SD = 0.71) 60 min post-block (P = 0.021). No side-effects were observed. There was no correlation between the number of FIB previously performed by the attending registrar and the improved maximal hip flexion (ρ = 0.090, P = 0.50) or reduction in subjective pain score (ρ = 0.005, P = 0.971). FIB performed by JR is a feasible, efficient pre-operative supplement to conventional pain-treatment for patients with hip fractures. FIB is easy to perform, requires minimal introduction, no expensive equipment and is connected with a minimal risk approach.


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