Proximal Femur Fracture Clinical Trial
Official title:
- Efficacy of Combined Lateral Femoral Cutaneous Nerve Block With Pericapsular Nerve Group Block Versus Fascia Iliaca Block in Proximal Femoral Fractures
This patient population is typically elderly and frail. They are at risk of adverse effects
secondary to inadequate pain management such as prolonged admissions and poor functional
outcomes.
Regional analgesia is preferred due to their opioid-sparing effects and reduction in related
adverse effects but The analgesia from these blocks is only moderate and literature suggests
that the obturator nerve (ON) is not covered.
The aim of this study is to compare the effect of combined lateral femoral cutaneous nerve
block with pericapsular nerve group block versus fascia iliaca block for proximal femur
surgery.
Fascia iliaca compartment block is a simple technique to manage pain before positioning for
spinal anesthesia performance and it constitutes a practical choice for perioperative pain
control.
A recent anatomical study confirmed the innervation of the anterior hip by these 3 main
nerves, but also found that the AON and FN play a greater role in the anterior hip
innervation than previously reported The high articular branches from FN and AON are
consistently found between the anterior inferior iliac spine (AIIS) and the iliopubic
eminence (IPE), whereas the ON is located close to the inferomedial acetabulum.
The ultrasound-guided technique for blockade of these articular branches to the hip, the PENG
(Pericapsular Nerve Group) block reported significantly reduced pain scores compared with
baseline. Roy et al 2019 recommended the use of PENG block together with LFCN block as
adjunctive to cover the lateral surgical incision.
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