Comparing of the analgesic effect of pericapsular ultrasound-guided nervegroup block and fascia iliaca block in patients with femoral head fracture forneuraxial block

Pelvic fractures are among the most severe injuries of the body's skeletal system, which areseen especially in the elderly and have high mortality and morbidity, and one of the most importantcomplications in this group of surgical procedures is pain. In this study, a comparative study of pericapsularnerve and fascia iliaca block analgesia in the positioning of patients with femoral neck fracture for neuraxialanesthesia was conducted.Materials and Methods: In this study, ۵۰ patients (each group as a pilot: ۲۵ patients) candidates for femoralneck fracture surgery referred to Imam Khomeini hospital in Urmia were included in a double-blind clinical trialto be randomly assigned (Using random allocation software) to be placed in two groups: pericapsular blockand iliac fascia block. Visual Analogue Scale (VAS) was used to evaluate analgesia. The pain level of thepatients was checked before the block, ۱۰ minutes after the block and before positioning for neuraxialanesthesia.Results: Regarding gender, ۳۸% (N=۱۹) were female and ۶۲% (N=۳۱) were male. The mean age of thepatients was ۵۷.۳۸±۸.۴۹ years (age range: ۵۳ to ۸۰ years) and no significant difference was observedbetween the two groups (P=۰.۳۱۵). The mean body mass index of the patients was ۲۶.۴۴±۳.۷۷ kg/m۲ (range:۱۹.۵۳ to ۳۴.۷ kg/m۲) and no significant difference was observed between the two groups (P=۰.۲۴۳). Themean pain ten minutes after the block was ۱.۷۲±۰.۷۳ in the pericapsular group and ۳.۹۲±۰.۸۶ in the fasciailiaca group, and a significant difference was observed between the two groups (P<۰.۰۰۱). The meandifference of pain before and after the block in the pericapsular and fascia iliaca groups was investigated anda significant difference was observed between the two groups, so that the pericapsular group showed agreater reduction in pain (P<۰.۰۰۱). Ten minutes after the block, the pain intensity was different in thepericapsular group and in the fascia iliaca, and there was no pain in the moderate pain in the pericapsulartreatment group, while ۱۶ patients (۶۴%) of the patients in the fascia iliaca group had moderate pain. Thedifferences were statistically significant (P<۰.۰۰۱).Conclusion: This study showed that pericapsular block provides far better analgesia for positioning than fasciailiaca block for patients with femoral neck fracture.

Keywords:

Pericapsular block , fascia iliaca block , femoral head fracture , neuraxial block