title: Fascia iliaca compartment block: its efficacy in pain control for patients with proximal femoral fracture.
abstract: BACKGROUND
  Proximal femoral fractures are common in elderly patients. Recently, use of regional blockade has gained popularity as a means of relieving pain among this patient population. Among the procedures, fascia iliaca compartment block (FICB) is believed to be advantageous because of its safety and efficacy.
  
  
  METHODS
  In this study fifty-six consecutive patients who sustained a proximal femoral fracture were assigned to two groups. For 31 patients in group 1, FICB was used to control pre and postoperative pain. FICB was performed by an orthopaedic resident on arrival of the patient at the hospital and in the immediate postoperative period. Systemic administration of non-steroidal anti-inflammatory drugs (NSAIDs) alone was adopted for pain control for 25 patients in group 2. The severity of pain was assessed by use of a visual analog scale (VAS).
  
  
  RESULTS
  Neither blockade-associated complications nor analgesic failure were encountered among patients who underwent FICB (group 1). In this group of patients, the mean preoperative VAS scores before FICB and at 10 min and 12 h after the blockade were 91, 31, and 36 respectively, indicating significant pain reduction. The corresponding values for group 2 patients were 92, 92, and 81. In addition, postoperative pain was also successfully managed by FICB with mean VAS scores at immediate, 6-h and 12-h time points of 15, 22, and 31 respectively, whereas the corresponding values for the group 2 patients were 62, 49, and 59. Consequently, significant differences in VAS scores were demonstrated between the groups in both the pre and postoperative periods.
  
  
  CONCLUSIONS
  FICB is clinically safe and efficient, providing consistent analgesic effects irrespective of the performing doctor's experience of elderly patients with proximal femoral fracture.
authors.affiliation: Department of Orthopedic Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, Japan, 663-8501, colon_6_wingroad@yahoo.co.jp.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Fujihara
authors.forename: Shigeo
authors.initials: S
authors.lastname: Fukunishi
authors.forename: Shoji
authors.initials: S
authors.lastname: Nishio
authors.forename: Jyuichi
authors.initials: J
authors.lastname: Miura
authors.forename: Sahoko
authors.initials: S
authors.lastname: Koyanagi
authors.forename: Shinichi
authors.initials: S
authors.lastname: Yoshiya
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005205:Fascia; D005260:Female; D006620:Hip Fractures / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods; D010146:Pain / Q000209:etiology*; D059408:Pain Management / Q000379:methods*