Karnataka Anaesthesia Journal

Open Access Open Access  Restricted Access Subscription Access

Comparison of Intrathecal Fentanyl and Femoral Nerve Block (FNB) for Post Operative Analgesia in Patients Undergoing Surgeries for Fracture Femur


Affiliations
1 Department of Anaesthesiology, Bangalore Medical College and Research Institute, Bangalore – 560002, Karnataka, India
 

Background and Aims: Femoral Nerve Block (FNB) has been advocated for pain relief in patients with fracture femur but its effect on post operative analgesia is less studied. The aim was to compare intrathecal fentanyl and FNB in terms of duration of complete analgesia and effective analgesia in the postoperative period and also for pain relief during positioning. Material and Methods: 64 ASA I-II patients, 18-60 years of age, with fracture shaft femur undergoing corrective surgery were randomly allocated to 2 groups, Group B and F. In the preoperative room, patients underwent FNB under ultrasound guidance. Group B patients were given bolus of 20 ml of 0.5% bupivacaine and Group F patients 20 ml normal saline. Following this, Group B patients received 2.5ml, 0.5% bupivacaine (heavy) with 0.5 ml normal saline. Group F patients received 2.5 ml, 0.5% bupivacaine (heavy) with 0.5 ml fentanyl (25 micrograms). Intraoperative and postoperative monitoring of vitals was done. Time of complete analgesia (VAS 0) and effective analgesia (VAS>/= 4), perioperative complications were noted. Results: Demographic parameters were comparable. The mean duration of complete analgesia was 273 ± 49.22 min in group F and 384.28 ± 89.04 min in group B (p = 0.01*). The duration of effective analgesia was 329.28 ± 50.86 min in group F compared to 457.14 ± 83.1min in group B (p = 0.004*). Postoperative VAS scores were significantly lower in group B than in group F. Incidence of nausea and vomiting was higher in group F (6 in group F and 1 in group B). Conclusion: FNB administered just before spinal anaesthesia provides better postoperative analgesia compared to intrathecal fentanyl.

Keywords

Femoral Nerve Block, Femur, Analgesia, Fentanyl
User
Notifications
Font Size

  • Ikeda S. Atlas of Flexible Bronchofiberoscopy, Baltimore, University Park, 1974.

  • Murphy P. A fibre-optic endoscope used for nasal intubation. Anaesthesia, 1967; 22:489-491. https://doi.org/10.1111/j.1365-2044.1967.tb02771.x. PMid:4951601.

  • Conyers AB, Wallace DH, Mulder DS. Use of the fiber optic bronchoscope for nasotracheal intubation: Case report. Can Anaesth Soc J, 1972; 19:654-656. https://doi.org/10.1007/ BF03006110. PMid:4635833.

  • Taylor PA, Towey RM. The broncho-fiberscope as an aid to endotracheal intubation. Br J Anaesth, 1972; 44:611-612. https://doi.org/10.1093/bja/44.6.611. PMid:5045554.

  • Stiles CM, Stiles QR, Denson JS. A flexible fiber optic laryngoscope. JAMA, 1972; 221:1246-1247. https://doi. org/10.1001/jama.221.11.1246, https://doi.org/10.1001/jama.1972.03200240028007.

  • Melissa W, Andranik O. Fiberoptic endoscopy. In: Benumof ’s Airway Management, Ed. Hagberg; 2nd ed. Mosby Elsevier; 2007. p. 399-438. https://doi.org/10.1016/B978-032302233-0.50025-1. PMid:17110498 PMCid:PMC1775017.

  • Orebaugh, Steven L. Atlas of airway management: Tools and techniques: 1st Edition: Lippincot Williams and Wilkins; 2007. p. 122-134.

  • Darling JR, Keohane M, Murray JM. A split laryngeal mask as an aid to training in fibreoptic tracheal intubation. A comparison with the Berman II intubating airway. Anaesthesia, 1993; 48:1079-1082. https://doi.org/10.1111/j.1365-2044.1993.tb07533.x. PMid:8285331.

  • Ovassapian A, Yelich SJ, Dykes MH, Golman ME. Learning fibreoptic intubation: Use of simulators v. traditional teaching. Br J Anaesth, 1988; 61:217-220. https://doi.org/10.1093/ bja/61.2.217. PMid:3415894.

  • Dykes MH, Ovassapian A. Dissemination of fibreoptic airway endoscopy skills by means of a workshop utilizing models. Br J Anaesth, 1989; 63:595-597. https://doi.org/10.1093/bja/63.5.595. PMid:2605077.


Abstract Views: 101

PDF Views: 60




  • Comparison of Intrathecal Fentanyl and Femoral Nerve Block (FNB) for Post Operative Analgesia in Patients Undergoing Surgeries for Fracture Femur

Abstract Views: 101  |  PDF Views: 60

Authors

Bhargavi Sanket
Department of Anaesthesiology, Bangalore Medical College and Research Institute, Bangalore – 560002, Karnataka, India
Swathi Nagaraja
Department of Anaesthesiology, Bangalore Medical College and Research Institute, Bangalore – 560002, Karnataka, India
Sudheesh Kannan
Department of Anaesthesiology, Bangalore Medical College and Research Institute, Bangalore – 560002, Karnataka, India
Nethra S. Surhonne
Department of Anaesthesiology, Bangalore Medical College and Research Institute, Bangalore – 560002, Karnataka, India

Abstract


Background and Aims: Femoral Nerve Block (FNB) has been advocated for pain relief in patients with fracture femur but its effect on post operative analgesia is less studied. The aim was to compare intrathecal fentanyl and FNB in terms of duration of complete analgesia and effective analgesia in the postoperative period and also for pain relief during positioning. Material and Methods: 64 ASA I-II patients, 18-60 years of age, with fracture shaft femur undergoing corrective surgery were randomly allocated to 2 groups, Group B and F. In the preoperative room, patients underwent FNB under ultrasound guidance. Group B patients were given bolus of 20 ml of 0.5% bupivacaine and Group F patients 20 ml normal saline. Following this, Group B patients received 2.5ml, 0.5% bupivacaine (heavy) with 0.5 ml normal saline. Group F patients received 2.5 ml, 0.5% bupivacaine (heavy) with 0.5 ml fentanyl (25 micrograms). Intraoperative and postoperative monitoring of vitals was done. Time of complete analgesia (VAS 0) and effective analgesia (VAS>/= 4), perioperative complications were noted. Results: Demographic parameters were comparable. The mean duration of complete analgesia was 273 ± 49.22 min in group F and 384.28 ± 89.04 min in group B (p = 0.01*). The duration of effective analgesia was 329.28 ± 50.86 min in group F compared to 457.14 ± 83.1min in group B (p = 0.004*). Postoperative VAS scores were significantly lower in group B than in group F. Incidence of nausea and vomiting was higher in group F (6 in group F and 1 in group B). Conclusion: FNB administered just before spinal anaesthesia provides better postoperative analgesia compared to intrathecal fentanyl.

Keywords


Femoral Nerve Block, Femur, Analgesia, Fentanyl

References