A comparative study of intravenous fentanyl and ultrasound-guided femoral nerve block for positioning during spinal anaesthesia in femur fracture surgeries

Dr Rajbala, Sonali Beniwal, M. Khandelwal, T. M. Thomas
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Abstract

Objective: To assist in the administration of spinal anesthesia for patients undergoing femur fracture procedures, we conducted comparison research to compare the analgesic efficiency of intravenous fentanyl against ultrasound-guided femoral nerve block (FNB). Material and Methods: A group of 112 patients ranging in age from 18 to 70 years old who had ASA Physical Status I and II and were having femur fracture procedures under spinal anaesthesia participated in the randomised, prospective, interventional trial. These individuals were divided into two groups through a random assignment process. Group FENT (n = 56) received Intravenous fentanyl 1 microgram/kilogram (µg/kg) and five minutes before positioning for spinal anaesthetic, group FNB (n = 56) received ultrasound-guided FNB with 20 millilitres (ml), 1.5% lignocaine and adrenaline (1:200,000). Results: Comparison of pain scores during positioning using the Visual Analog Scale (VAS) revealed that Group FENT had a score of 1.95 ± 0.585, whereas Group FNB had a score of 0.61 ± 0.562 (p-value 0.001). The FNB group demonstrated superior patient positioning quality. Patient satisfaction was similar in both groups, and no significant side effects were observed. Conclusion: FNB offers enhanced analgesia, improved patient positioning, higher patient satisfaction, reduced reliance on additional analgesia, and fewer side effects compared to intravenous fentanyl for spinal anesthesia.
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股骨骨折手术脊柱麻醉时静脉注射芬太尼与超声引导股神经阻滞定位的比较研究
目的:为了辅助股骨骨折手术患者的脊髓麻醉给药,我们进行了对比研究,比较静脉注射芬太尼与超声引导下股骨神经阻滞(FNB)的镇痛效果。材料和方法:112例年龄在18至70岁之间,ASA身体状态为I和II,在脊柱麻醉下进行股骨骨折手术的患者参加了随机、前瞻性、介入性试验。这些人通过随机分配过程被分成两组。FENT组(n = 56)静脉注射芬太尼1微克/千克(µg/kg),体位前5分钟进行脊髓麻醉;FNB组(n = 56)超声引导下FNB加20毫升(ml)、1.5%利多卡因和肾上腺素(1:20万)。结果:采用视觉模拟评分法(VAS)进行体位疼痛评分比较,FENT组体位疼痛评分为1.95±0.585,FNB组体位疼痛评分为0.61±0.562 (p值0.001)。FNB组表现出较好的患者体位质量。两组患者满意度相似,无明显副作用。结论:与静脉芬太尼相比,FNB可增强镇痛,改善患者体位,提高患者满意度,减少对额外镇痛的依赖,副作用更少。
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