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Randomized Controlled Trial Observational Study
Comparison of USG Guided or Landmark Approach Fascia Iliaca Compartment Block for Positioning in Elderly Hip Fracture Patients with Spinal Anesthesia: a randomized controlled observational study.
- Tuna Ertürk, Ibrahim Gündoğmuş, Temel Güner, Cengiz Yildirim, and Ayşin Ersoy.
- Department of Anesthesiology, University of Health Sciences, Sultan 2. Abdülhamid Han Training and Research Hospital, İstanbul, Turkey
- Turk J Med Sci. 2021 Dec 13; 51 (6): 290829142908-2914.
Background/AimCurrently, the elderly population in the world is rapidly increasing due to technological developments and convenient access to health services. Due to comorbidities in elderly patients, hip fractures are frequently observed after exposure to environmental trauma. To reduce pain during positioning in spinal anesthesia, fascia iliaca compartment block (FICB) can be applied easily and reliably. In our study, we aimed to compare the analgesic effects and duration of fascia iliaca compartment blocks performed with USG guidance or the landmark approach methods for relieving spinal anesthesia position pain.Materials And MethodsOur study included 100 patients undergoing operations due to hip fracture and administered spinal anesthesia after FICB. The group with USG-guided FICB (USG) had the blockage needle advanced to the compartment under the fascia iliaca, and 15 mL bupivacaine + 10 mL 2% lidocaine was administered. They were placed in sitting position for spinal anesthesia 20 min later and procedure duration and numerical rating scale (NRS) scores were recorded. In the group with landmark approach FICB (LAND), the spina iliaca anterior superior (SIAS) and pubic tubercle were connected with a line. The same amount of local anesthetic was administered to the external 1/3 portion of this line with the double pop technique. Procedure duration and NRS scores were recorded.ResultsThere was no statistically significant difference between the two groups in terms of NRS scores (p: 0.073). There was a statistically significant difference in duration of FICB administration between the two groups (p < 0.001).ConclusionBoth USG-guided and landmark approach FICB methods provide adequate and similar analgesia for positioning in spinal anesthesia. However, in cases where there is no problem with access to the ultrasound device or time, safer blockage can be provided by imaging neurovascular structures with ultrasound.This work is licensed under a Creative Commons Attribution 4.0 International License.
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