A randomized controlled trial of femoral nerve blockade administered preclinically for pain relief in femoral trauma.
BACKGROUND
Analgesia at the location of the accident and on transport for femoral trauma is often delayed or insufficient. In this prospective, randomized, controlled study, we evaluated the preclinical use of femoral nerve blockade for reducing pain and anxiety compared with IV analgesia using metamizol.


METHODS
Patients with painful femoral trauma, such as fracture or severe contusion, were randomized to receive at the site of the accident a femoral nerve blockade (n = 31) or IV analgesia with metamizol (n = 31). A visual analog scale (VAS) was used to assess pain and anxiety. Variables were assessed at baseline, during transport and upon arrival at the hospital.


RESULTS
In patients receiving the femoral nerve blockade, pain values decreased by half from VAS 86 +/- 6 mm at the site of the accident to VAS 41 +/- 15 mm during transport. Anxiety decreased by half from VAS 84 +/- 11 mm to VAS 39 +/- 14 mm. Heart rate decreased by 20 +/- 5 bpm. In the metamizol group, pain, anxiety, and heart rate did not decrease (P < 0.001). Time of treatment was 7.4 +/- 3.5 min longer in the femoral nerve blockade group.


CONCLUSIONS
Preclinically administered femoral nerve blockade effectively decreases pain, anxiety, and heart rate after femoral trauma. Regional blockade is an option for out-of-hospital analgesia administered by a trained physician.
Schiferer
Arno
A
Department of Anesthesiology and General Intensive Care, Medical University of Vienna, Austria. arno.schiferer@meduniwien.ac.at
Gore
Carmen
C
Gorove
Laszlo
L
Lang
Thomas
T
Steinlechner
Barbara
B
Zimpfer
Michael
M
Kober
Alexander
A
D000328:Adult; D000368:Aged; D001340:Autonomic Nerve Block / Q000379:methods*; D005260:Female; D005267:Femoral Nerve / Q000187:drug effects / Q000293:injuries* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy* / Q000473:pathology; D010147:Pain Measurement / Q000187:drug effects / Q000379:methods*; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies