Femoral nerve block for acute pain relief in fracture shaft femur in an emergency ward

Abstract

Background: Analgesia in patients with fracture shaft femur is usually insufficient as physician usually relies on parental analgesia in such situations. Local anesthetic blockade of femoral nerve to provide analgesia in fracture shaft femur is an under-used technique. We conducted a study to evaluate the efficacy of femoral nerve block (FNB) with 0.5% ropivacaine for acute pain relief in patients with fracture shaft femur. Materials and Methods: A total of 50 patients were studied as they present in an emergency ward. All patients received an FNB with 15 ml of 0.5% ropivacaine. The onset of block, duration of analgesia, patient′s acceptance after 24 h together with the effect of block were assessed. Results: The onset of analgesia occurred in 5.34 ± 1.10 min after the block. Pain scores decreased significantly from 9.12 ± 0.9, preblock visual analog scale (VAS) score to 1.84 ± 1.25, VAS score at 10 min after the block (P < 0.001). The quality of analgesia did not change when patient underwent radiological examination (38.9 ± 5.22 min after block) and traction application (69.4 ± 8.98 min after block). The duration of analgesia observed was 227 ± 63.99 min. Patient acceptance after 24 h of FNB was good in 86% patients. There were no side effects. Conclusions: It was concluded that in the emergency ward, rapid, effective, and long lasting analgesia can be achieved by safe and simple FNB in patients with fracture shaft femur.

Keywords

• Femoral nerve block
• fracture shaft femur
• ropivacaine