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Background and Aims Peripheral nerve blocks rather than systemic analgesia are usually used in older patients with fracture neck femur. In this study, we compared fascia iliaca vs PENG with LFCN block for fracture neck of femur surgery.
Methods Geriatric group of patients of age 70 years or over, ASA 2 & 3 with body weight 50 to 90 Kg were included in our study. Out of 40 patients, 20 were taken alternatively for fascia iliaca (Gr-F) or in PENG with LFCN (Gr-P) group. Drugs mixture for the nerve blocks contained equal volume of 2% Lidocaine in adrenalin and 0.5% bupivacaine (plain) with 10 mg dexamethasone. Ultrasound-guided peripheral nerve block was performed with 40ml for FI block in Gr-F and 30ml ml and 10 ml respectively in Gr-P for PENG and LFCN blocks. VRS was assessed 30 minutes following the nerve block procedure. All patients received CSE with 10 mg Bupivacaine heavy for spinal anesthesia and Inj. dexmedetomidine infusion at 0.5 mic/kg/hr for sedation as our routine anesthetic technique in the intraoperative period. Pain, hemodynamics, complications, timing of initiation of epidural infusion were studied.
Results Students T test was applied for the analysis. During positioning VRS score at 30min was Gr-P 1.15 (± 0.344), in Gr-F it was 2.2 (± 0.589) (p<0.0256). Per-operative hemodynamic responses were not significantly different (P<0.08). Duration of analgesia in Gr-P was 16.96 (±1.86) hours and Gr-F 13.69 (± 1.04) hours with P value <0.293.
Conclusions PENG with LFCN block revealed better analgesic quality during positioning for CSE performance in our study.
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