COMPARISON OF FASCIA ILIACA COMPARTMENT BLOCK AND INTRAVENOUS FENTANYL FOR ANALGESIA DURING POSITIONING FOR SPINAL ANESTHESIA IN HIP FRACTURE SURGERIES
Authors: Patil Priyanka , B. Patil Pratima , Patil Priyanka , Sheelavantar Jyothi 
Published: January 2025

Effective pain management in hip fracture surgeries is crucial for optimal recovery. Spinal anesthesia is commonly used but positioning patients can be challenging, especially in frail, elderly individuals. Two main approaches for managing pain during positioning are the fascia iliaca compartment block (FICB) and intravenous fentanyl. FICB, a regional anesthesia technique, targets the lumbar plexus, providing longer-lasting pain relief with fewer systemic side effects compared to opioids. It reduces the need for additional analgesics, improving patient comfort and reducing intraoperative complications. FICB is especially beneficial in elderly patients with comorbidities. Intravenous fentanyl offers rapid pain relief but has a shorter duration and carries risks such as respiratory depression, sedation, and nausea, particularly in the elderly. Frequent dosing may lead to inconsistent pain control. Studies show that FICB provides superior pain relief and fewer side effects than fentanyl, making it a preferable choice for hip fracture surgeries. This study aims to compare their efficacy.

Objective:

1. To study the effect of analgesia for positioning during spinal anaesthesia using VAS

score in fascia iliaca compartment block and intravenous fentanyl

2. To compare the effect of analgesia in fascia iliaca compartment block and intravenous

fentanyl

3. The time taken for giving spinal anaesthesia

Materials and method: This study is on patients undergoing hip fracture surgery under subarachnoid block and was done in basaweshwara teaching and general hospital,MR medical college gulbarga. It was a Prospective interventional study included 60consented patients of age group 30 to 60 years belonging to American society of anesthesiologists class I or II and posted for hip fracture surgery under subarachnoid block.

Results: This study included 60 patients, 30 in each group. Group A-30 patients received preoperative USG fascia iliaca compartment block.Group B- 30 patients received 1mcg/kg IV fentanyl 5 minute before placing in sitting position for spinal blockade. The mean Visual Analog Scale (VAS) score during positioning was significantly lower in Group A (1.13 Â± 1.25) compared to Group B (2.33 Â± 1.58) with a highly significant difference (p<0.001), while the mean time to perform spinal anesthesia was significantly shorter in Group A (4.79 Â± 0.54 minutes) than in Group B (5.14 Â± 0.57 minutes), with a p-value of 0.017 the age distribution between the two groups showed no significant difference, with 46.7% of Group A and 66.7% of Group B in the 51-60 age group (p=0.143).

Conclusion: In conclusion, the Fascia Iliaca Compartment Block is a superior analgesic technique compared to intravenous fentanyl for providing pain relief during positioning for spinal anesthesia in patients undergoing hip fracture surgeries. The benefits of FICB, including effective pain relief, prolonged analgesia, and reduced side effects, make it a valuable tool in optimizing pain management in this patient population.