title: Ultrasound-guided fascia iliaca compartment block in orthopedic fractures: Bupivacaine 0.2% or 0.3%?
abstract: Background:Postoperative pain is one of the major problems in patients with femoral or hip fracture. Current study investigates the effect of 0.2% and 0.3% bupivacaine in ultrasound-guided fascia iliaca compartment block (FICB) on postoperative pain.Methods:This randomized clinical trial study was conducted in Rasoul Akram Hospital of Iran University of Medical Sciences. Forty-eight patients with femoral or hip fractures who were candidates for surgery underwent FICB, divided into two groups receiving bupivacaine in 0.2% and 0.3% concentrations. Pain was evaluated with Visual Analog Scale (VAS) at times 2, 6, 12, 24, and 48 hours after surgery. Need for opioids, nausea and vomiting after surgery, patients' satisfaction with pain control and motor block were also recorded. T-test or Mann- Whitney U test and Repeated measure ANOVA was used for analysis.Results:Pain score after surgery was significantly lower in groups receiving 0.3% than the group receiving 0.2% concentration. Patients' satisfaction with pain control in 0.2% group was significantly higher (p=0.04). Time to analgesic onset in both groups had no significant differences (p=0.5). The incidence of nausea and vomiting (p=0.5) and opioid consumption (p=0.1) between the two groups showed no significant difference.Conclusion:In femoral or hip fracture, bupivacaine with 0.3% concentration in fascia iliaca compartment block can cause lower pain score compared to bupivacaine with 0.2% concentration, but patients' satisfaction with pain control and severity of motor block is higher in bupivacaine 0.2%.
authors.affiliation: Associate Professor of Anesthesiology, Pain Research Center, Iran University of Medical Sciences, Tehran, Iran. poupak_rah@hotmail.com.
authors.forename: Poupak
authors.initials: P
authors.lastname: Rahimzadeh
authors.affiliation: Professor of Anesthesiology, Pain Research Center, Iran University of Medical Sciences, Tehran, Iran. farnadimani@yahoo.com.
authors.forename: Farnad
authors.initials: F
authors.lastname: Imani
authors.affiliation: Assistant Professor of Community and Preventive Medicine, Center for Academic and Health Policy, Tehran University of Medical Sciences.
authors.forename: Azadeh
authors.initials: A
authors.lastname: Sayarifard
authors.affiliation: Resident of Anesthesiology, Iran University of Medical Sciences, Tehran, Iran. drsayarifard@gmail.com.
authors.forename: Sara
authors.initials: S
authors.lastname: Sayarifard
authors.affiliation: Associate Professor of Anesthesiology, Endometriosis and gynecologic disorders Research Center, Iran University of Medical Sciences, Tehran, Iran. hrfaiz@hotmail.com.
authors.forename: Seyed Hamid Reza
authors.initials: SH
authors.lastname: Faiz
keywords: Bupivacaine; Fascia iliac block; Postoperative pain