title: Intravenous analgesia with opioids versus femoral nerve block with 0.2% ropivacaine as preemptive analgesic for fracture femur: A randomized comparative study.
abstract: OBJECTIVE
  Femoral fractures are extremely painful and pain invariably worsens on any movement. Anesthesia for fracture femur surgery is usually provided by spinal block. This study was undertaken to compare the analgesic effects of femoral nerve block (FNB) using nerve stimulator with 0.2% ropivacaine (15 ml) and intravenous (I.V.) fentanyl before patient positioning for fracture femur surgery under spinal anesthesia.
  
  
  METHODS
  A prospective, randomized, double-blind, comparative study was conducted on 60 American Society of Anesthesiologists I and II patients (18-60 years) scheduled for femur surgery under combined spinal epidural anesthesia. Patients in Group I (n = 30), were administered FNB using nerve stimulator with 0.2% ropivacaine (15 ml) and in Group II patients (n = 30), I.V. fentanyl 0.5 μg/kg was given as preemptive analgesia. Parameters observed included time to spinal anesthesia, intra-operative and postoperative visual analog scale (VAS) for any pain and postoperative epidural top-ups dosages.
  
  
  RESULTS
  Demographic profile was comparable in both the groups. VAS at 2 min in Group I was 5.63 and in Group II it was 8.00. Satisfaction score was better in Group I as compared to Group II patients. Time to administer subarachnoid block was 17.80 min in patients of Group I as compared to 25.03 min in Group II patients. Postoperatively, VAS scores were lower in Group I than Group II patients. The frequency of epidural top-ups was higher in Group II than in Group I patients.
  
  
  CONCLUSIONS
  FNB is comparatively better in comparison to I.V. fentanyl when used as preemptive and postoperative analgesic in patients being operated for fracture femur.
authors.affiliation: Department of Anaesthesia and Critical Care, SGRD Medical College and Hospital, Amritsar, Haryana, India.
authors.forename: Arvinder Pal
authors.initials: AP
authors.lastname: Singh
authors.affiliation: Department of Anaesthesia and Critical Care, SGRD Medical College and Hospital, Amritsar, Haryana, India.
authors.forename: Vaneet
authors.initials: V
authors.lastname: Kohli
authors.affiliation: Department of Anaesthesiology and Intensive Care, Adesh Hospital, Shahbad, Kurukshetra, Haryana, India.
authors.forename: Sukhminder Jit Singh
authors.initials: SJ
authors.lastname: Bajwa
keywords: Femoral nerve block; fentanyl; fracture femur; ropivacaine