Fascia Iliaca vs Femoral Nerve Block in Hip Fracture Patients

Summary

Hip fractures are common orthopedic injuries, especially in older adults, and surgical repair such as hip arthroplasty is often required. Effective pain control is essential in these patients to allow proper positioning for spinal anesthesia, reduce patient discomfort, and improve overall perioperative outcomes.

Two commonly used regional anesthesia techniques for pain relief in hip fracture patients are the Fascia Iliaca Compartment Block (FICB) and the Femoral Nerve Block (FNB). Both techniques aim to block pain signals from the femoral nerve and related nerves supplying the hip region. However, there is ongoing debate regarding which technique provides better analgesia during positioning for spinal anesthesia.

This study is a prospective, randomized controlled trial conducted at Central Park Teaching Hospital, Lahore. A total of 80 patients scheduled for hip arthroplasty will be enrolled and randomly divided into two equal groups. Group A will receive Fascia Iliaca Compartment Block, while Group B will receive Femoral Nerve Block. All patients will subsequently undergo spinal anesthesia as part of standard surgical care.

The primary objective of the study is to compare the effectiveness of FICB and FNB in reducing pain during patient positioning for spinal anesthesia. Pain will be measured using the Numeric Rating Scale (NRS), which is a standard 0-10 pain scoring system, assessed before the nerve block and during positioning for spinal anesthesia.

Standard monitoring will be used in all patients, including blood pressure, pulse oximetry, and electrocardiography. Both techniques will be performed using standard local anesthetic agents. Rescue analgesia will be provided if required to ensure patient safety and comfort.

Data will be analyzed using appropriate statistical methods, and pain scores will be compared between the two groups. A p-value of ≤0.05 will be considered statistically significant.

The study aims to determine which regional anesthesia technique provides superior analgesia during spinal anesthesia positioning in hip fracture patients. The findings may help improve pain management strategies, enhance patient comfort, and optimize perioperative care in orthopedic surgery.

Conditions

• Hip Fracture
• Postoperative Pain
• Peripheral Nerve Block
• Femoral Nerve

Interventions

PROCEDURE

Fascia Iliaca Compartment Block (FICB)

Fascia Iliaca Compartment Block (FICB) was administered prior to spinal anesthesia under aseptic conditions using the anatomical landmark technique. A needle was inserted below the inguinal ligament to access the fascia iliaca compartment. After confirmation of correct placement by loss of resistance and negative aspiration, 0.3 ml/kg of 1.5% lignocaine with adrenaline was injected. This approach aimed to block the femoral, lateral femoral cutaneous, and obturator nerves, providing broader analgesic coverage for the hip region during positioning for spinal anesthesia.

Sponsors & Collaborators

• Central Park Teaching Hospital, Lahore

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

20 Years

Max Age

70 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2024-06-10

Primary Completion

2024-12-09

Completion

2024-12-09

Countries

• Pakistan

Study Locations