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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; The Author(s).


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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  1. Danish Orthopaedic Society; reference program concerning hip fracture—2006
  2. Foss NB, Kehlet H (2005) Mortality analysis in hip fracture patients: implications for design of future outcome trials. Br J Anaesth 94(1):24-29
  3. Heikkinen T, Parker M, Jalovaara P (2001) Hip fractures in Finland and Great Britain—a comparison of patient characteristics and outcomes. Int Orthop 25(6):349-354
  4. Morau D, Lopez S, Biboulet P, Bernard N, Amar J, Capdevila X (2003) Comparison of continuous 3-in-1 and fascia iliaca compartment blocks for postoperative analgesia: feasibility, catheter migration, distribution of sensory block, and analgesic efficacy. Reg Anesth Pain Med 28(4):309-314
  5. Capdevila X, Biboulet P, Bouregba M, Barthelet Y, Rubenovitch J, d'Athis F (1998) Comparison of the three-in-one and fascia iliaca compartment blocks in adults: clinical and radiographic analysis. Anesth Analg 86(5):1039-1044
  6. Dalens B, Vanneuville G, Tanguy A (1989) Comparison of the fascia iliaca compartment block with the 3-in-1 block in children. Anesth Analg 69(6):705-713
  7. Zibigniew Koscielniak-Nielsen. perifere nerveblokader ved hjælp af elektronisk nervestimulation. 2006
  8. Parker MJ, Palmer CR (1993) A new mobility score for predicting mortality after hip fracture. J Bone Joint Surg Br 75(5):797-798
  9. Hindsø K (1998) Prevention of hip fractures using external hip protectors. Risk factors for falls, hip fractures, and mortality; and evaluation of the consequences of fear of falling among older orthopaedic patients. A clinical, controlled, open intervention study including 1,684 patients, older than 74 years of age, followed for 1-2.5 years after admittance to one of two university hospitals in Copenhagen. Ph.d. Thesis, University of Copenhagen (Cited 2008 Feb 6). http//
  10. Candal-Couto JJ, McVie JL, Haslam N, Innes AR, Rushmer J (2005) Pre-operative analgesia for patients with femoral neck fractures using a modified fascia iliaca block technique. Injury 36(4):505-510
  11. Gros T, Bassoul B, Dareau S, Delire V, Roche B, Eledjam JJ (2006) Postoperative neuropathy following fascia iliaca compartment blockade. Ann Fr Anesth Reanim 25(2):216-217
  12. Jensen MP, Chen C, Brugger AM (2002) Postsurgical pain outcome assessment. Pain 99(1-2):101-109
  13. Cuignet O, Mbuyamba J, Pirson J (2005) The long-term analgesic efficacy of a single-shot fascia iliaca compartment block in burn patients undergoing skin-grafting procedures. J Burn Care Rehabil 26(5):409-415
  14. Lopez S, Gros T, Bernard N, Plasse C, Capdevila X (2003) Fascia iliaca compartment block for femoral bone fractures in prehospital care. Reg Anesth Pain Med 28(3):203-207
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