Assessment of Different Approaches to Resolve Positioning Pain Before
Spinal Anesthesia in Hip Fractures
Abstract
Aim Currently, the population in the world is rapidly increasing due to
technological developments and convenient access to health services. Due
to comorbidities in elderly patients, hip fractures are frequently
observed after exposure to environmental trauma. To reduce pain during
positioning in spinal anesthesia, fascia iliaca compartment block (FICB)
can be applied easily and reliably. Material and Method Our study
included 100 patients undergoing operations due to hip fracture and
administered spinal anesthesia after FICB. The group with FICB
accompanied by ultrasound (USG) had the blockage needle advanced to the
compartment under the fascia iliaca and 15 mL bupivacaine + 10 mL 2%
lidocaine was administered. Sitting position was given for spinal
anesthesia 20 minutes later and procedure duration and NRS scores were
recorded. In the group with FICB completed with the landmark method
(LAND), the spina iliaca anterior superior (SIAS) and pubic tubercle
were connected with a line. The same amount of local anesthetic was
administered to the external 1/3 portion of this line with the double
pop technique. Procedure durations and NRS scores were recorded. Results
There was no statistically significant difference between the groups in
terms of NRS scores (p>0.05). There was a statistical
difference found in terms of FICB administration durations
(p<0.05). Conclusion FICB administered both with USG and using
the anatomic landmark method provides sufficient analgesia for the
positioning stage of spinal anesthesia at similar levels. However,
imaging of structures with ultrasound will provide more reliable
blockage when there is access to the device and no time problems.