Comparing Analgesic Effect of Intravenous Fentanyl, Femoral Nerve Block and Fascia Iliaca Block During Spinal Anesthesia Positioning in Elective Adult Patients Undergoing Femoral Fracture Surgery: a Randomized Controlled Trial
Melaku Bantie,1 Simeneh Mola,2 Timsel Girma,2 Zemedu Aweke,2 Derartu Neme,2 Abebayehu Zemedkun2 1Debre Berhan University, College of Medicine and Health Science, Debre Birhan, Ethiopia; 2Dilla University, College of Medicine and Health Science, Dilla, EthiopiaCorrespondence: Simeneh MolaDilla Univer...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2020-11-01
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| Series: | Journal of Pain Research |
| Subjects: | |
| Online Access: | https://www.dovepress.com/comparing-analgesic-effect-of-intravenous-fentanyl-femoral-nerve-block-peer-reviewed-article-JPR |
| _version_ | 1818932471702487040 |
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| author | Bantie M Mola S Girma T Aweke Z Neme D Zemedkun A |
| author_facet | Bantie M Mola S Girma T Aweke Z Neme D Zemedkun A |
| author_sort | Bantie M |
| collection | DOAJ |
| description | Melaku Bantie,1 Simeneh Mola,2 Timsel Girma,2 Zemedu Aweke,2 Derartu Neme,2 Abebayehu Zemedkun2 1Debre Berhan University, College of Medicine and Health Science, Debre Birhan, Ethiopia; 2Dilla University, College of Medicine and Health Science, Dilla, EthiopiaCorrespondence: Simeneh MolaDilla University, College of Medicine and Health Science, Dilla 0419/13, EthiopiaTel +251 901091414Email ksimenehmola@yahoo.comBackground: Femoral fracture is the most painful bone injury and performing spinal anesthesia is extremely challenging due to very poor positioning unless we have a very good mode of analgesia. Intravenous strong opioids are commonly used but to date nerve blocks are also being utilized. The reliability and effectiveness of the aforementioned methods are not conclusive to practice worldwide. The objective of the study was to compare the analgesic effect of intravenous fentanyl, femoral nerve block (FNB) and fascia iliaca block (FICB) during positioning patients with femoral fracture for spinal anesthesia.Methods: A randomized controlled trial study was conducted on 72 elective adult patients with femoral fracture aged 18– 65 years and ASA I and II those were allocated randomly into three groups. The intravenous fentanyl (IVFE) group received 1μg/kg IV fentanyl, FNB group received nerve stimulator guided FNB with 30 mL of 1% lidocaine with adrenaline and FICB group received FICB with 30 mL of 1% lidocaine with adrenaline. Pain intensity in numeric rating score (NRS), time to perform spinal anesthesia, quality of positioning and patient acceptance were assessed. SPSS version 26 and Kruskal–Wallis test were used to analyze data and p value < 0.05 was considered significant.Results: NRS Pain score during positioning was significantly lower in FNB and FICB groups than IVFE group [median (IQR)]; 2 (1– 2.5), 2 (2– 3)) vs. 3 (3– 4) respectively; P< 0.001 and P=0.001. However, FNB and FICB groups were not significantly different with (P=1.000). Time to perform spinal anesthesia was significantly longer in IVFE group 9.5 (9– 10) minutes than both FNB and FICB groups 7 (6– 8), 8 (6– 8) respectively, P< 0.001. The quality of positioning was significantly lower in the IVFE group than both FNB and FICB groups (P< 0.001).Conclusion: Preoperative FNB and FICB reduce pain score during positioning, shorten time to perform spinal anesthesia, better patient positioning and higher patient acceptance in a patient undergoing elective femoral bone fracture surgery.Trial Registration: Pan African Clinical Trial Registry, PACTR202006669166858, registered on June 19, 2020. https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=12127.Keywords: femoral nerve block; FNB, fascia iliaca block; FICB, intravenous fentanyl, spinal anesthesia positioning, femoral fracture |
| first_indexed | 2024-12-20T04:33:01Z |
| format | Article |
| id | doaj.art-0bfad26b02564f4db74b3a72125f072c |
| institution | Directory Open Access Journal |
| issn | 1178-7090 |
| language | English |
| last_indexed | 2024-12-20T04:33:01Z |
| publishDate | 2020-11-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Pain Research |
| spelling | doaj.art-0bfad26b02564f4db74b3a72125f072c2022-12-21T19:53:20ZengDove Medical PressJournal of Pain Research1178-70902020-11-01Volume 133139314659713Comparing Analgesic Effect of Intravenous Fentanyl, Femoral Nerve Block and Fascia Iliaca Block During Spinal Anesthesia Positioning in Elective Adult Patients Undergoing Femoral Fracture Surgery: a Randomized Controlled TrialBantie MMola SGirma TAweke ZNeme DZemedkun AMelaku Bantie,1 Simeneh Mola,2 Timsel Girma,2 Zemedu Aweke,2 Derartu Neme,2 Abebayehu Zemedkun2 1Debre Berhan University, College of Medicine and Health Science, Debre Birhan, Ethiopia; 2Dilla University, College of Medicine and Health Science, Dilla, EthiopiaCorrespondence: Simeneh MolaDilla University, College of Medicine and Health Science, Dilla 0419/13, EthiopiaTel +251 901091414Email ksimenehmola@yahoo.comBackground: Femoral fracture is the most painful bone injury and performing spinal anesthesia is extremely challenging due to very poor positioning unless we have a very good mode of analgesia. Intravenous strong opioids are commonly used but to date nerve blocks are also being utilized. The reliability and effectiveness of the aforementioned methods are not conclusive to practice worldwide. The objective of the study was to compare the analgesic effect of intravenous fentanyl, femoral nerve block (FNB) and fascia iliaca block (FICB) during positioning patients with femoral fracture for spinal anesthesia.Methods: A randomized controlled trial study was conducted on 72 elective adult patients with femoral fracture aged 18– 65 years and ASA I and II those were allocated randomly into three groups. The intravenous fentanyl (IVFE) group received 1μg/kg IV fentanyl, FNB group received nerve stimulator guided FNB with 30 mL of 1% lidocaine with adrenaline and FICB group received FICB with 30 mL of 1% lidocaine with adrenaline. Pain intensity in numeric rating score (NRS), time to perform spinal anesthesia, quality of positioning and patient acceptance were assessed. SPSS version 26 and Kruskal–Wallis test were used to analyze data and p value < 0.05 was considered significant.Results: NRS Pain score during positioning was significantly lower in FNB and FICB groups than IVFE group [median (IQR)]; 2 (1– 2.5), 2 (2– 3)) vs. 3 (3– 4) respectively; P< 0.001 and P=0.001. However, FNB and FICB groups were not significantly different with (P=1.000). Time to perform spinal anesthesia was significantly longer in IVFE group 9.5 (9– 10) minutes than both FNB and FICB groups 7 (6– 8), 8 (6– 8) respectively, P< 0.001. The quality of positioning was significantly lower in the IVFE group than both FNB and FICB groups (P< 0.001).Conclusion: Preoperative FNB and FICB reduce pain score during positioning, shorten time to perform spinal anesthesia, better patient positioning and higher patient acceptance in a patient undergoing elective femoral bone fracture surgery.Trial Registration: Pan African Clinical Trial Registry, PACTR202006669166858, registered on June 19, 2020. https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=12127.Keywords: femoral nerve block; FNB, fascia iliaca block; FICB, intravenous fentanyl, spinal anesthesia positioning, femoral fracturehttps://www.dovepress.com/comparing-analgesic-effect-of-intravenous-fentanyl-femoral-nerve-block-peer-reviewed-article-JPRfemoral nerve blockfascia iliaca blockintravenous fentanylspinal anesthesia positioningfemoral fracture |
| spellingShingle | Bantie M Mola S Girma T Aweke Z Neme D Zemedkun A Comparing Analgesic Effect of Intravenous Fentanyl, Femoral Nerve Block and Fascia Iliaca Block During Spinal Anesthesia Positioning in Elective Adult Patients Undergoing Femoral Fracture Surgery: a Randomized Controlled Trial Journal of Pain Research femoral nerve block fascia iliaca block intravenous fentanyl spinal anesthesia positioning femoral fracture |
| title | Comparing Analgesic Effect of Intravenous Fentanyl, Femoral Nerve Block and Fascia Iliaca Block During Spinal Anesthesia Positioning in Elective Adult Patients Undergoing Femoral Fracture Surgery: a Randomized Controlled Trial |
| title_full | Comparing Analgesic Effect of Intravenous Fentanyl, Femoral Nerve Block and Fascia Iliaca Block During Spinal Anesthesia Positioning in Elective Adult Patients Undergoing Femoral Fracture Surgery: a Randomized Controlled Trial |
| title_fullStr | Comparing Analgesic Effect of Intravenous Fentanyl, Femoral Nerve Block and Fascia Iliaca Block During Spinal Anesthesia Positioning in Elective Adult Patients Undergoing Femoral Fracture Surgery: a Randomized Controlled Trial |
| title_full_unstemmed | Comparing Analgesic Effect of Intravenous Fentanyl, Femoral Nerve Block and Fascia Iliaca Block During Spinal Anesthesia Positioning in Elective Adult Patients Undergoing Femoral Fracture Surgery: a Randomized Controlled Trial |
| title_short | Comparing Analgesic Effect of Intravenous Fentanyl, Femoral Nerve Block and Fascia Iliaca Block During Spinal Anesthesia Positioning in Elective Adult Patients Undergoing Femoral Fracture Surgery: a Randomized Controlled Trial |
| title_sort | comparing analgesic effect of intravenous fentanyl femoral nerve block and fascia iliaca block during spinal anesthesia positioning in elective adult patients undergoing femoral fracture surgery a randomized controlled trial |
| topic | femoral nerve block fascia iliaca block intravenous fentanyl spinal anesthesia positioning femoral fracture |
| url | https://www.dovepress.com/comparing-analgesic-effect-of-intravenous-fentanyl-femoral-nerve-block-peer-reviewed-article-JPR |
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