Pain Score after Fascia Iliaca Compartment Block for Acute PAIN Management in Hip Fractures at Tertiary Care Hospital
DOI:
https://doi.org/10.70749/ijbr.v3i7.1957Keywords:
Pain Score, Movement, Rest, Fascia Iliac Compartment Block, Acute Pain, Hip FracturesAbstract
Background: Managing pain associated with hip fractures is a significant challenge. Fascia iliaca compartment block is a local anaesthetic injection that may provide good analgesia. Objective: To compare the pain score on movement and at rest among patients with and without fascia iliac compartment block for acute pain management in hip fractures. Material and Methods: This randomized controlled study included 124 participants. Patients were randomly assigned to two groups: Group-A had a fascia iliac compartment block (FICB), whereas Group-B did not. Pain evaluations were performed pre-operatively at 0-minutes, 15-minutes, 2-hours, and 6-hours using visual analogue scale (VAS). SPSS was used for data analysis. The normality of the data was evaluated. Quantitative variables were presented as median (IQR). Qualitative variables were presented as frequency and percentages. Group comparisons were performed with the Mann-Whitney U test, with significance established at p≤0.05. Results: Patients who received FICB were mostly female (56.5%) and more often categorized as ASA 3 (12.9%), in contrast to the absence of such classification in the NO FICB group (p=0.011). The age distribution was similar (p=0.088). FICB was correlated with markedly reduced pain ratings at rest and during movement at all time intervals (p<0.001). Preoperative analgesic intake was significantly decreased (p<0.001), and the duration of hospital stay was abbreviated (p<0.001). Conclusion: The fascia iliaca compartment block offers enhanced short-term analgesia preoperatively, both at rest and during movement. It also reduces the preoperative analgesia consumption and hospital stay.
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References
1. Li J, Chen H, Zuo J, Zhang X. Effect of fascia iliaca compartment block combined with ropivacaine on post-operative outcomes in elderly patients undergoing hip fracture repair. Pak J Med Sci. 2024;40(4):757-62.
https://doi.org/10.12669/pjms.40.4.8283
2. Li X, Xu J. Comparison of proximal femoral nail antirotation and total hip arthroplasty in the treatment of femoral intertrochanteric fracture. Pak J Med Sci. 2022;38(4Part-II):1016-20.
https://doi.org/10.12669/pjms.38.4.5830
3. Balzan I, Balzan C. The use of preoperative Fascia Iliaca Compartment Block (FICB) as an effective form of analgesia in adult patients with hip fractures: A systematic review. J Orthopaed Traum Car. 2025;6(1):12 pages
4. Wennberg P, Möller M, Herlitz J, Sarenmalm EK. Fascia iliaca compartment block as a preoperative analgesic in elderly patients with hip fractures–effects on cognition. BMC Geriatr. 2019;19:1-8.
https://doi.org/10.1186/s12877-019-1266-0
5. Dhanwal DK, Dennison EM, Harvey NC, Cooper C. Epidemiology of hip fracture: worldwide geographic variation. Indian J Orthop. 2011;45(1):15–22.
https://doi.org/10.4103/0019-5413.73656
6. Povoroznyuk VV, Grygorieva NV, Kanis JA, McCloskey EV, Johansson H, Strafun SS, et al. Epidemiology of hip fractures in two regions of Ukraine. J Osteoporos. 2018;2018:1-6.
https://doi.org/10.1155/2018/7182873
7. Swenning T, Leighton J, Nentwig M, Dart B. Hip fracture care and national systems: the United States and Canada. Ota Intern. 2020;3(1):73.
https://doi.org/10.1097/oi9.0000000000000073
8. Chen FP, Fu TS, Lin YC, Fan CM. Risk factors and quality of life for the occurrence of hip fracture in postmenopausal women. Bio Med J. 2018;41(3):202-8.
https://doi.org/10.1016/j.bj.2018.04.001
9. Trevisan C, Gallinari G, Carbone AKR, Klumpp R. Fifteen years change in acute management of hip fracture patients: 1-year mortality calls for improvements. Injury. 2021;52(8):2367-72.
10. Houserman DJ, Raszewski JA, Palmer B, Chavan B, Sferrella A, Campbell M, et al. The impact of the fascia iliaca block beyond perioperative pain control in hip fractures: a retrospective review. Geriatr Orthopaed Surg Rehab. 2022;13:1-8.
https://doi.org/10.1177/21514593221099107
11. Wennberg P, Andersson H, Sundstrom BW. Patients with suspected hip fracture in the chain of emergency care: an integrative review of the literature. Int J Orthop Trauma Nurs. 2018;29:16-31
12. Foss NB, Kristensen BB, Bundgaard M, Bak M, Heiring C, Virkelyst C, et al. Fascia iliaca compartment blockade for acute pain control in hip fracture patients: a randomized, placebo-controlled trial. J Ame Soci Anesthesiol. 2007;106(4):773-8.
https://doi.org/10.1097/01.anes.0000264764.56544.d2
13. Rowlands M, van de Walt G, Bradley J, Mannings A, Armstrong S, Bedforth N, et al. Femoral nerve block intervention in neck of femur fracture (FINOF): a randomized controlled trial. BMJ Open. 2018;8(4):1-8
14. Connolly KP, Kleinman RS, Stevenson KL, Neuman MD, Mehta SN. Delirium reduced with intravenous acetaminophen in geriatric hip fracture patients. J Am Acad Orthopaed Surg. 2020;28(8):325-31.
https://doi.org/10.5435/jaaos-d-17-00925
15. Heyzer L, Ramason R, Molina JAC, Chan WWL, Loong CY KE, Kwek E. Integrated hip fracture care pathway (IHFCP): reducing complications and improving outcomes. Singapore Med J. 2021;10:1-16
https://doi.org/10.11622/smedj.2021041
16. Biz C, Fantoni I, Crepaldi N, Zonta F, Buffon L, Corradin M, et al. Clinical practice and nursing management of pre-operative skin or skeletal traction for hip fractures in elderly patients: a cross-sectional three-institution study. Intern J Orthopaed Trauma Nurs. 2019;32:32-40.
17. Matullo KS, Gangavalli A, Nwachuku C. Review of lower extremity traction in current orthopaedic trauma. J Am Acad Orthopaed Surg. 2016;24(9):600-6.
https://doi.org/10.5435/jaaos-d-14-00458
18. Dalens B, Vanneuville G, and Tanguy A. Comparison of the fascia iliaca compartment block with the 3-in-1 block in children. Anesth Analg 1989;69:705-13.
19. Kit WT, Chak HY, Hang LK, Keung CK, Ming LK, Chung TC, et al. Randomized controlled trial on analgesic effect of pre-operative fascia iliaca compartment block in geriatric patients with hip fracture. J Orthopaed Traum Rehabil. 2024;31(2):187-94.
https://doi.org/10.1177/22104917241227621
20. Hanna L, Gulati A, and Graham A. The role of fascia iliaca blocks in hip fractures: a prospective case-control study and feasibility assessment of a junior-doctor-delivered service. ISRN Ortho. 2014;2014:191306.
21. Fujihara Y, Fukunishi S, Nishio S. Fascia iliaca compartment block: its efficacy in pain control for patients with proximal femoral fracture. J Orthop Sci. 2013;18:793-97.
https://doi.org/10.1007/s00776-013-0417-y
22. Amin NH, West JA, Farmer T. Nerve blocks in the geriatric patient with hip fracture: a review of the current literature and relevant neuroanatomy. Geriatr Orthop Surg Rehabil. 2017;8:268-75.
23. Foss NB, Kristensen BB, Bundgaard M. Fascia iliaca compartment blockade for acute pain control in hip fracture patients: a randomized, placebo-controlled trial. Anesthesiol. 2007;106:773-78.
https://doi.org/10.1097/01.anes.0000264764.56544.d2
24. Lopez S, Gros T, Bernard N. Fascia iliaca compartment block for femoral bone fractures in prehospital care. Reg Anesth Pain Med. 2003;28:203-07.
25. Elkhodair S, Mortazavi J, Chester A. Single fascia iliaca compartment block for pain relief in patients with fractured neck of femur in the emergency department: a pilot study. Eur J Emerg Med. 2011;18:340-43.
https://doi.org/10.1097/mej.0b013e32834533dd
26. Ma Y, Wu J, Xue J. Ultrasound-guided continuous fascia iliaca compartment block for pre-operative pain control in very elderly patients with hip fracture: a randomized controlled trial. Exp Ther Med. 2018;16:1944-52.
27. Kingston M, Jones J, Black S, Evans B, Ford S, Foster T, et al. Clinical and cost-effectiveness of paramedic administered fascia iliaca compartment block for emergency hip fracture (RAPID 2) protocol for an individually randomised parallel-group trial. Trials. 2022;23(1):677-91
https://doi.org/10.1186/s13063-022-06522-3
28. Verbeek T, Adhikary S, Urman R, Liu H. The application of fascia iliaca compartment block for acute pain control of hip fracture and surgery. Current Pain Headache Report. 2021;25:1-9.
29. Wennberg P, Norlin R, Herlitz J, SarenmalmEK, Möller M. Pre-operative pain management with nerve block in patients with hip fractures: a randomized, controlled trial. Int J Orthop Trauma Nurs. 2019;33:35-43.
https://doi.org/10.1016/j.ijotn.2018.11.003
30. Hao C, Li C, Cao R, Dai Y, Xu C, Ma L, et al. Effects of Perioperative Fascia Iliaca Compartment Block on Postoperative Pain and Hip Function in Elderly Patients With Hip Fracture. Geriatr Orthopaed Surg Rehabilit. 2022;13:1-8.
31. Wan HY, Li SY, Ji W, Yu B, Jiang N. Fascia Iliaca Compartment Block for Perioperative Pain Management of Geriatric Patients with Hip Fractures: A Systematic Review of Randomized Controlled Trials. Hindawi Pain Res Manage. 2020;2020:8503963, 12 pages
https://doi.org/10.1155/2020/8503963
32. Foss NB, Kristensen BB, Bundgaard M. Fascia iliaca compartment blockade for acute pain control in hip fracture patients: a randomized, placebo-controlled trial. Anesthesiol. 2007;106(4):773-8.
33. Koehler RM, Okoroafor UC, Cannada LK. A systematic review of opioid use after extremity trauma in orthopedic surgery. Injury. 2018;49(6):1003-7.
https://doi.org/10.1016/j.injury.2018.04.003
34. Gaffney CJ, Pelt CE, Gililland JM, Peters CL. Perioperative pain management in hip and knee arthroplasty. Orthop Clin N Am. 2017;48(4):407-19.
35. Wennberg P, M¨oller M, Herlitz J, Kenne Sarenmalm E. Fascia iliaca compartment block as a preoperative analgesic in elderly patients with hip fractures - effects on cognition. BMC Geriatrics. 2019;19(1):252.
https://doi.org/10.1186/s12877-019-1266-0
36. Yamamoto N, Sakura S, Noda T. Comparison of the postoperative analgesic efficacies of intravenous acetaminophen and fascia iliaca compartment block in hip fracture surgery: A randomized controlled trial. Injury. 2019;50(10):1689-93.
37. Ma Y, Wu J, Xue J, Lan F, Wang T. Ultrasoundguided continuous fascia iliaca compartment block for preoperative pain control in very elderly patients with hip fracture: a randomized controlled trial. Experiment Terape Med. 2018;16(3):1944-52.
https://doi.org/10.3892/etm.2018.6417
38. Fujihara Y, Fukunishi S, Nishio S, Miura J, Koyanagi S, Yoshiya S. Fascia iliaca compartment block: its efficacy in pain control for patients with proximal femoral fracture. J Orthopaed Sci. 2013;18(5):793-7.
39. Steenberg J, Møller AM. Systematic review of the effects of fascia iliaca compartment block on hip fracture patients before operation. Br J Anaesth. 2018;120(6):1368-80.
https://doi.org/10.1016/j.bja.2017.12.042
40. Magaziner J, Simonsick EM, Kashner TM, Hebel JR, Kenzora JE. Predictors of functional recovery one year following hospital discharge for hip fracture: A prospective Study. J Gerontol. 1990;45(3):101-7.
https://doi.org/10.1093/geronj/45.3.m101
41. Thompson J, Long M, Rogers E, et al. Fascia iliaca block decreases hip fracture postoperative opioid consumption: A prospective randomized controlled trial. J Orthop Trauma. 2020;34(1):49-54.
https://doi.org/10.1097/bot.0000000000001634
42. Leung JM, Sands LP, Lim E, Tsai LT, Kinjo S. Does preoperative risk for delirium moderate the effects of postoperative pain and opiate use on postoperative delirium? Am J Geriatr Psychiatry. 2013;21(10):946-56.
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