Background and Aims A Fractured neck of Femur can cause severe pain. There is overwhelming evidence that peripheral nerve blocks are effective in providing analgesia for this injury and reduce serious complications such as the risk of acute confusion, chest infection and time to first mobilisation.1
In 2018 a landmark Fascia Iliaca Block (FIB) service was set up at the Queen’s Medical Centre in Nottingham. Since then, there have been new national recommendations supporting the use of ultrasound to provide a more accurate deposition of local anaesthetic and superior block.2,3
Methods Retrospective data collection on 101 patients who attended the emergency department with a neck of femur fracture. Their notes were reviewed electronically for information on demographics, FIB delivery, pain scores and opioid requirements post block. Ethical approval was sought for this project.
Results Approximately 71% of patients received a FIB, the main contraindication was anticoagulation. Levobupivacaine 0.25% was the local anaesthetic of choice. 87% of the blocks were performed by doctors, the remaining by advanced nurse practitioners. 92% were performed via the landmark technique. Approximately 77% of patients scored either moderate or severe pain pre-block, decreasing to approximately 18% post-block. Approximately 39% of patients required analgesia 12 hours post block, and the mean opioid requirements were 3 mg of oxycodone.
Conclusions There has been a significant increase in the number of FIB rates (71%) since 2018 when the average was 8%. Despite this improvement, there is still scope to increase the efficacy. The use of an ultrasound-guided technique will facilitate this change.
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