US-guided FICB After Hip Fracture: the Effect of the Local Anesthetic Volume on the Quality of Preoperative Analgesia

Study Overview
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Brief Summary
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participants were randomly divided into three groups : group 30 , group 40 and group 50 . for all the three groups an ultrasound guided supra-inguinal fascia iliaca block had been performed. for group 30 ,a volume of 30 ml of 0,2 % ropivacaine had been injected for group 40 ,a volume of 40 ml of 0,2 % ropivacaine had been injected for group 50 ,a volume of 50 ml of 0,2 % ropivacaine had been injected

Detailed Description
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participants were randomly divided into three groups : group 30 , group 40 and group 50 . for all the three groups an ultrasound guided supra-inguinal fascia iliaca block had been performed. A linear ultrasound probe was placed in the sagittal plane to obtain an image of the superior iliac spine.the fascia iliaca and sartorious,iliopsoas,and oblique internal muscles were identified by sliding the probe medially. After identifiying the bow-tie signformed by the muscle fascias , an 50 mm needle was introduced 1-2 cm inferior to the inguinal ligament.using an in-plane approch, the fascia iliaca was penetrated and hydrodissected , separating the fascia iliaca from the iliac muscle. in this created space a total volume of 30 ml, 40ml or 50ml of 0.2% ropivacaine was injected , respectively to group 30 ,group 40 and group 50 . pain score at rest and with a straight leg raise of the affected limb to 15 degrees were assessed before and 30 minutes after block performance.

Official Title
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Ultrasound-guided Fascia Iliaca Compartment Block After Hip Fracture : the Effect of the Local Anesthetic Volume on the Quality of Preoperative Analgesia

Conditions
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Hip Fractures

Intervention / Treatment
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* Procedure: supra inguinal fascia iliaca block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients aged above 65 years , american society of anesthesiologists physical status I to III , and with body mass index (BMI) of 35 kg/m² or less , undergoing hip fracture surgical repair . Exclusion Criteria: inability or refusal to sign informed consent younger than 65 years BMI greater than 35 kg/m² presence of contraindications for regional nerve block or spinal anesthesia impaired cognition or dementia multiple fractures

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: group 30<br>participants received a supra inguinal fascia iliaca compartment block with 30 ml of 0.2% ropivacaine | Procedure: supra inguinal fascia iliaca block<br>* injection of 30,40 or 50 ml of 0.2 ropivacaine .<br>|
| Experimental: group 40<br>participants received a supra inguinal fascia iliaca compartment block with 40 ml of 0.2% ropivacaine | Procedure: supra inguinal fascia iliaca block<br>* injection of 30,40 or 50 ml of 0.2 ropivacaine .<br>|
| Experimental: group 50<br>participants received a supra inguinal fascia iliaca compartment block with 50 ml of 0.2% ropivacaine | Procedure: supra inguinal fascia iliaca block<br>* injection of 30,40 or 50 ml of 0.2 ropivacaine .<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| change in pain score on movement | change in verbal ranking scale(( vrs) with 0 indicating no pain and 10 indicating the worst imaginable pain)) during passive leg elevation to 15 degrees of the affected limb , before and 30 minutes after block placement | before and 30 minutes after block placement | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| change in pain score at rest | change in verbal ranking scale(( vrs) with 0 indicating no pain and 10 indicating the worst imaginable pain)) at rest, before and 30 minutes after block placement | before and 30 minutes after block placement | 
| assessement of sensory block | sensory assessment of Femoral nerve , obturator nerve, and lateral femoral cutaneous nerve using the cold test . in the anterior , medial and lateral aspects of the thigh. | 30 minutes after block placement |