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Fascia Iliaca Compartment Block for Femoral Bone Fractures in Prehospital Care
  1. Sandrine Lopez, M.D.,
  2. Thierry Gros, M.D.,
  3. Nathalie Bernard, M.D.,
  4. Christian Plasse, M.D. and
  5. Xavier Capdevila, M.D., Ph.D.
  1. From the Department of Anesthesia and Critical Care Medicine, Lapeyronie University Hospital (S.L., N.B., C.P., X.C.), and Beau Soleil Clinic (T.G.), Montpellier, France.
  1. Reprint requests: Xavier Capdevila, M.D., Ph.D., Département d’Anesthésie Réanimation A, Hôpital Lapeyronie, 371 avenue du Doyen Giraud, 34295 Montpellier, France. E-mail: capdevila{at}


Background and Objectives The fascia iliaca compartment block provides a faster and more consistent simultaneous blockade of the lateral cutaneous and femoral nerves than the “3 in 1” block. We studied the effectiveness of this technique for analgesia after a femoral bone fracture in pre-hospital care.

Methods Patients with an isolated femoral shaft fracture were included. A fascia iliaca compartment block was performed on all of them. Twenty milliliters of lidocaine 1.5 % with epinephrine were injected under the fascia iliaca. The intensity of pain was measured using a simplified verbal scale (SVS) from 0 (no pain) to 4 (extreme pain). The SVS was noted before the block was performed, 10 minutes later, and then on admission to the trauma care center. Sensory blockade was evaluated using cold perception in the lateral, medial, and internal part of the thigh 10 minutes after block performance and on arrival at the trauma care center.

Results Twenty-seven patients were enrolled in this study. The SVS was 3 (3-4) before the block, 1 (0-2) 10 minutes after the block, and 0 (0-1) when arriving at the trauma care center (P < .05). The SVS was lower when the internal part of the thigh was blocked.

Conclusion The fascia iliaca compartment block is a simple, inexpensive, and effective method of prehospital analgesia for femoral shaft fracture. A sensory block of the internal part of the thigh is an early predictive sign of optimal pain relief.

  • Regional analgesia
  • Prehospital care
  • Femoral shaft fractures

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  • Presented in part at the ASA Annual Congress, New Orleans, LA, October 13-17, 2001.