Fascia Iliaca Compartment Block in the Emergency Room in Hip Fracture and Shaft of Femur Fractures

Abstract

Fascia iliaca block, a well-established method of local anesthesia, is underused in the emergency department. This study aimed
at assessing the efficacy, ease of administration by a junior doctor, and the reduction of opioid requirement in patients with
fractures of hip and shaft of femur. In this prospective randomized blinded case-control study, 57 patients were randomly
assigned into case and control groups to receive 0.25% ropivacaine and 0.9% normal saline (NS) in the fascia iliaca space,
respectively, with fentanyl as on demand analgesia titrated to response in both groups. There was a significant difference
between the two groups in the visual analog scale between 2 and 6 hours. The reduction in pain score was statistically
significant in the case group (from its baseline) compared to the control group (from its baseline). The opioid requirement
was also significantly reduced in the case group compared to the control group. The study was effective in demonstrating
that fascia iliaca block was successful at reducing the need for opioid analgesia and that it could be performed without much
complication by a relatively inexperienced clinician.