Impact of Ultrasound-Guided Femoral Nerve Block on Ease of Positioning for Spinal Anesthesia in Patients with Femoral Fracture

Abstract

Background: Spinal anesthesia is commonly used for orthopedic surgeries. The most important issue to improve outcome is patient cooperation to have a proper position for reducing pain during spinal anesthesia procedure. However, any change in position is painful which leads to sympathetic activation, tachycardia and hypertension, which may put patients with ischemic heart disease at risk. Peripheral nerve block is a safe and reliable alternative to systemic analgesia. Using the ultrasound-guided method reduces local anesthetics’ amount and side effects.

Methods: In this study, 53 patients who came to the operating room with femoral fracture as candidates for spinal anesthesia were enrolled and received ultrasound-guided Femoral Nerve Block (FNB) (10 ml Lidocaine 1.5%). Before and after receiving the nerve block, the patients were asked about the severity of their pain using the Numerical Rating Scale (NRS). Both groups of patients and physicians were asked about their satisfaction according to a 5-point Likert scale.

Results: Mean pain intensity in the NRS score at the time of admission to the operating room was 7.6±0.8, which was reduced to 1.8±1.5 after blockade. In this study, 39 (73.5%) patients were very satisfied (Likert scale 5), 10 (18.8%) were satisfied (Likert scale 4), 2 (3.7%) had no opinion (Likert scale 3), 2 (3.7%) were not satisfied (Likert scale 2), and no one was very dissatisfied (Likert scale 1). There was significant difference in physician’s satisfaction.

Conclusion: Ultrasound-guided nerve block is a safe and effective method to be used for positioning during spinal anesthesia procedure.