Ultrasound-Guided Preoperative Fascia Iliaca Compartment Block for Pain Relief During Positioning for Spinal Anesthesia in Patients With Hip Fracture.

Background Fractures around the hip are common in the elderly. For surgical management, the subarachnoid block is the preferred anesthesia technique. Positioning these patients for anesthesia is challenging because of pain. Analgesia in the form of preoperative perineural anesthesia is gaining popularity. We observed the analgesic efficacy of preoperative ultrasound-guided fascia iliaca block, its efficacy during positioning for spinal anesthesia, pain scores, and anesthesiologist comfort while administering spinal anesthesia. Methodology An observational study was conducted on patients of 40 to 80 years under the American Society of Anesthesiologists (ASA) physical status I-III, requiring hip surgeries under spinal anesthesia. After pre-anesthetic evaluation, the purpose and protocol of the study were explained to patients, and informed consent was obtained. Pain score using the numeric rating scale (NRS) was recorded. Ultrasound-guided suprainguinal fascia iliaca block was performed using 30 ml of 0.25% levobupivacaine one hour before shifting to the operating room. Pain scores were reassessed. Spinal anesthesia was administered in the operating theatre in a sitting position. Pain during positioning was assessed. Results The mean NRS score reduced significantly after ultrasound-guided suprainguinal fascia iliaca block. The mean NRS score was 3.25 during positioning for spinal anesthesia compared to a pre-block score of 9.03, noting a statistically significant reduction (p=0.001). Conclusion Fascia Iliaca compartment block (FICB) helps alleviate the pain of hip fractures and makes positioning the subarachnoid block easier.