Ultrasound-guided femoral nerve blocks are not superior to ultrasound-guided fascia iliaca blocks for fractured neck of femur

Emerg Med Australas. 2019 Jun;31(3):393-398. doi: 10.1111/1742-6723.13172. Epub 2018 Sep 9.

Abstract

Objective: To determine if an ultrasound-guided femoral nerve block (FNB) is superior to an ultrasound-guided fascia iliaca compartment block (FICB) in providing pain relief to patients with a neck of femur or proximal femoral fracture.

Methods: A double-blind randomised controlled trial was conducted. All participants received two blocks, one active and one placebo. An active FICB was administered to 52 participants and 48 participants received an active FNB.

Results: Analysis was completed on data collected from 100 participants. Most patients were elderly and the majority were female. Both FICB and FNB achieved clinically significant mean reductions in pain scores (2.62 for FICB and 2.3 for FNB). There was no significant difference in reduction in pain scores between the two cohorts, P = 0.408.

Conclusions: Ultrasound-guided FNB is not superior to ultrasound-guided FICB, with both facilitating an equivalent analgesia effect in patients with a neck of femur or proximal femur fracture.

Keywords: analgesia; fascia iliaca; femoral; hip fracture; nerve block.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Analgesia / methods
  • Analgesia / standards
  • Analgesia / statistics & numerical data
  • Double-Blind Method
  • Fascia / drug effects*
  • Female
  • Femoral Artery / drug effects*
  • Femoral Neck Fractures / complications
  • Femoral Neck Fractures / drug therapy*
  • Humans
  • Male
  • Middle Aged
  • Nerve Block / methods
  • Nerve Block / standards*
  • Nerve Block / statistics & numerical data
  • Pain Measurement / methods
  • Ultrasonography, Interventional / methods
  • Ultrasonography, Interventional / standards*
  • Ultrasonography, Interventional / statistics & numerical data