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Comparison of USG Guided or Landmark Approach Fascia Iliaca Compartment Block for Positioning in Elderly Hip Fracture Patients with Spinal Anesthesia: a randomized controlled observational study

Turk J Med Sci. 2021 Jul 4. doi: 10.3906/sag-2011-254. Online ahead of print.

ABSTRACT

BACKGROUND/AIM: Currently, the elderly population in the world is rapidly increasing due to technological developments and convenient access to health services. Due to comorbidities in elderly patients, hip fractures are frequently observed after exposure to environmental trauma. To reduce pain during positioning in spinal anesthesia, fascia iliaca compartment block (FICB) can be applied easily and reliably. In our study, we aim to compare the analgesic effects and duration of Fascia iliaca compartment blocks performed Usg guided or Landmark approach methods in relieving spinal anesthesia position pain.

MATERIALS AND METHODS: Our study included 100 patients undergoing operations due to hip fracture and administered spinal anesthesia after FICB. The group USG guided FICB(USG) had the blockage needle advanced to the compartment under the fascia iliaca and 15 mL bupivacaine + 10 mL 2% lidocaine was administered. Sitting position was given for spinal anesthesia 20 minutes later and procedure duration and Numerating Rating Scale(NRS) scores were recorded. In the group Landmark approach FICB(LAND), the spina iliaca anterior superior (SIAS) and pubic tubercle were connected with a line. The same amount of local anesthetic was administered to the external 1/3 portion of this line with the double pop technique. Procedure duration and NRS scores were recorded.

RESULTS: There was no statistically significant difference between two groups in terms of NRS scores (p>0.05). There was a statistical difference duration of FICB administration between two groups(p<0.05).

CONCLUSION: Both USG-guided and landmark approach FICB methods provide adequate and similar analgesia for positioning spinal anesthesia. However, in cases where there is no problem of access to the ultrasound device or time problem, a safer blockage can be made by imaging neurovascular structures with ultrasound.

PMID:34217171 | DOI:10.3906/sag-2011-254

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