Article Text
Abstract
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Background and Aims A retrospective evaluation of the analgesic efficacy of two nerve block techniques used in patients with neck of femur fracture before positioning them for spinal anaesthesia. Technique A: pericapsular nerve group (PENG) block, femoral and lateral femoral cutaneous nerve block and technique B: femoral and lateral femoral cutaneous nerve block. Intravenous propofol and alfentanil boluses were used in both techniques as a rescue measure to manage pain during positioning and spinal anaesthesia.
Methods Twenty-nine trauma patients with neck of femur fractures who underwent hemiarthroplasty surgery between Feb 2022- Feb 2023 were included. Retrospective data were collected from anaesthetic charts. Only patients with documented normal cognitive status who underwent spinal anaesthesia on the left lateral position with the fractured side uppermost were included. Both blocks in techniques A and B were performed preoperatively and intended to provide peri and postoperative analgesia. The analgesic efficacy for both techniques was assessed by the number of times rescue intravenous propofol and alfentanil boluses were used to manage pain during positioning and spinal anaesthesia procedure. The z-test statistical test was used to analyse the results.
Results Patients who received Technique A required fewer intravenous propofol and alfentanil blouses during positioning. No intravenous boluses were needed during the spinal anaesthesia procedure, providing better analgesia quality than Technique B with a p-value of 1.13×10 ^(-7).
Conclusions Adding a PENG block to femoral and lateral femoral cutaneous nerve blocks provided better analgesia for positioning and spinal anaesthesia than femoral and lateral cutaneous nerve blocks alone.