A Comparative Study between Femoral Nerve Block and Intravenous Ketamine in Pain Management for Elderly Patients with Femur Fracture during Positioning before

Abstract

atients with fractures are always scared of pain. The psychological, clinical, and behavioral impacts of pain are numerous. Many researches have been conducted to provide relief from this annoying experience during preoperative, intraoperative and postoperative periods. Femur fracture commonly occurs following trauma in elderly patients and central neuraxial block especially spinal anesthesia is more preferred for providing anesthesia for such cases. Proper positioning during spinal anesthesia is a must for a successful procedure, but extreme pain and limb immobility are obstacles for an ideal position for this procedure. Different methods like intravenous fentanyl, ketamine, femoral nerve block or fascia iliaca block have been used to control the pain pre-operatively and improve these patients' positioning. Results are inconsistent regarding the efficiency of FNB over IV analgesia. Some studies showed the superiority of the femoral nerve block when compared to intravenous opioids. However, other studies showed no benefit of FNB over IV opioids.