Analgesic Efficacy of Ultrasound Guided FICB in Patients with Hip Fracture

Introduction: Hip fractures are often encountered in the elderly and present special problems to the anaesthesiologist. Fascia iliaca compartment block is another technique with the intent to block all the three nerves like 3-in-1 nerve block. Aim: To evaluate the analgesic efficacy of ultrasound guided fascia iliaca compartment block to facilitate positioning of patients with hip fracture for spinal anaesthesia. Materials and Methods: This prospective study was conducted in 50 patients aged between 40-80 years, belonging to American Society of Anesthesiologists (ASA) physical status I-III undergoing surgery for hip fracture. All 50 patients received an ultrasound guided Fascia Iliaca Compartment Block (FICB) in the premedication room with 30 mL of 0.5% ropivacaine by 23G spinal needle. Sensory blockade was evaluated 5, 10 and 20 minutes after ropivacaine administration using loss of perception to cold in the lateral, anterior and medial part of the thigh. Visual analogue scale scores were noted before the block, 20 minutes after block and during positioning for spinal anaesthesia. Patient’s acceptance for FICB was evaluated 24 hour after arriving back to the orthopaedics ward using a twopoint score. Any episode of hypotension or bradycardia was noted and managed accordingly. Results: In lateral part of thigh, at 5 minutes sensory blockade was present in 33 patients (66%) and at 10 minutes sensory blockade was present in 45 cases (90%). In anterior part of thigh, sensory blockade was present in 34 cases (68%) at 5 minutes time interval and at 10 minutes sensory blockade was present in 48 cases (96%). In medial part of thigh, 28 cases (56%) had sensory blockade at 5 minutes and at 10 minutes in 43 cases (86%). Sensory blockage was same at 20 minutes as on 10 minutes interval in all thigh parts. Before FIC block average VAS was 7.5 which was decreased to average of 2.94 at 20 minutes after block which was statistically significant (p