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

Høgh A, Dremstrup L, Jensen SS, Lindholt J - Strategies Trauma Limb Reconstr (2008)

Bottom Line: 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 (rho = 0.090, P = 0.50) or reduction in subjective pain score (rho = 0.005, P = 0.971).

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Viborg District Hospital, Viborg, Denmark, a_l_hogh@yahoo.dk.

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 degrees (SD = 17) this improved to a median of 28 degrees (SD = 21) 15 min post-block (P = 0.014) and 37 degrees (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 (rho = 0.090, P = 0.50) or reduction in subjective pain score (rho = 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.

No MeSH data available.


Related in: MedlinePlus

Anatomy of fascia iliaca compartment. 1 fascia lata, 2 fascia iliaca, 3 N. femoralis, 4 N. cutaneus femoris lateralis, 5 V. og A. femoralis, 6 M. pectinale, 7 M. psoas
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC2553430&req=5

Fig2: Anatomy of fascia iliaca compartment. 1 fascia lata, 2 fascia iliaca, 3 N. femoralis, 4 N. cutaneus femoris lateralis, 5 V. og A. femoralis, 6 M. pectinale, 7 M. psoas

Mentions: Identification of the correct compartment is based on two ‘gives’ followed by a loss of resistance; first ‘give’ felt is fascia lata and second is fascia iliaca. We use an “obtuse” needle (45° cut) to make it easier to feel the ‘give’ (see Fig. 2). The block is performed with 30 ml bupivacaine (2.5 mg/ml) and 10 ml lidocaine (2%). In patients weighing less than 50 kg the quantity is reduced by half.Fig. 2


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

Høgh A, Dremstrup L, Jensen SS, Lindholt J - Strategies Trauma Limb Reconstr (2008)

Anatomy of fascia iliaca compartment. 1 fascia lata, 2 fascia iliaca, 3 N. femoralis, 4 N. cutaneus femoris lateralis, 5 V. og A. femoralis, 6 M. pectinale, 7 M. psoas
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2553430&req=5

Fig2: Anatomy of fascia iliaca compartment. 1 fascia lata, 2 fascia iliaca, 3 N. femoralis, 4 N. cutaneus femoris lateralis, 5 V. og A. femoralis, 6 M. pectinale, 7 M. psoas
Mentions: Identification of the correct compartment is based on two ‘gives’ followed by a loss of resistance; first ‘give’ felt is fascia lata and second is fascia iliaca. We use an “obtuse” needle (45° cut) to make it easier to feel the ‘give’ (see Fig. 2). The block is performed with 30 ml bupivacaine (2.5 mg/ml) and 10 ml lidocaine (2%). In patients weighing less than 50 kg the quantity is reduced by half.Fig. 2

Bottom Line: 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 (rho = 0.090, P = 0.50) or reduction in subjective pain score (rho = 0.005, P = 0.971).

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Viborg District Hospital, Viborg, Denmark, a_l_hogh@yahoo.dk.

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 degrees (SD = 17) this improved to a median of 28 degrees (SD = 21) 15 min post-block (P = 0.014) and 37 degrees (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 (rho = 0.090, P = 0.50) or reduction in subjective pain score (rho = 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.

No MeSH data available.


Related in: MedlinePlus