Preoperative Analgesia using Ultrasound Guided Femoral Nerve Block Followed by Spinal Anesthesia Vs. Spinal Anesthesia Alone in Patients with Fracture Femu

Abstract

atients with a fracture of the femoral shaft present special problem to the anesthesiologist. The femoral shaft is subject to major muscle forces that, especially in young patients, can deform the thigh and angulate the bone fragments thus complicating the intraoperative reduction of the fracture (Salvatore et al., 2004). Therefore complete paralysis of the muscles acting on the femur is mandatory (Salvatore et al., 2004). Spinal anesthesia is routinely used. However any overriding of the fracture ends is extremely painful, and the procedure of the patient positioning to perform a spinal block always requires the administration of a large amounts of IV analgesics (Salvatore et al., 2004). Femoral nerve block has been shown to be an effective method of analgesia for fractured femoral shaft when it is performed either during pre-hospital management or in the emergency department and also can provide excellent postoperative analgesia (Salvatore et al., 2004). In the present study, 60 patients aged 20 to 60 years old or more of both sexes were divided into two groups, underwent major lower limb surgery under regional anesthesia at Ain Shams University Hospitals. There was no significant difference among both groups as regard age, sex, weight and ASA status.