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Abstract
Background and Aims Post-operative pain in the elderly is associated with adverse surgical outcome and Post-Operative Cognitive Dysfunction (POCD) in the elderly (1). It is rather common in the orthopedic population and it is related to the type of fracture as well as procedure performed by the surgeons. As a matter of a fact, even patients under epidural analgesia regiments have shown increased pain walking after Intra-Medullary Hip Screw (IMHS) compared to other procedures (2). Fascia Iliaca Plane Block has been found to reduce pain after hip fracture (3). Thus, we decided to study its effect in post-surgical patients.
Methods 16 patients were studied in this case- control trial. Approval of local ethics committee was obtained. Their demographic characteristics are presented in Table 1. Control group was administered 2.5 mL ropivacaine and 10 mcg fentanyl intrathecally and study group was administered 1.5 mL ropivacaine and 10 mcg fentanyl intrathecally, while fascial iliaca plane block (40 mL of 0.375% ropivacaine) was performed pre-operatively. VAS scores of patients were measured in the PACU, 24 hours and 48 hours after operation.
Results Patients from both group noted significantly higher VAS scores at rest after 24 hours compared to PACU (p<0.001). Nevertheless, pain was higher in the Ropi group compared to Fascia group at 24 and 48 hours (p<0.001). (Figure1) (Figure2)
Conclusions Fascia iliaca plane block combined with low dose spinal anesthesia significantly reduces VAS score at rest compared to regular dose spinal anesthesia. It remains a field of interest for future research.