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Anesth Analg 2004;99:1221-1224
© 2004 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000134812.00471.44

REGIONAL ANESTHESIA

Analgesia Before Performing a Spinal Block in the Sitting Position in Patients with Femoral Shaft Fracture: A Comparison Between Femoral Nerve Block and Intravenous Fentanyl

Salvatore Sia, MD, Francesco Pelusio, MD, Remo Barbagli, MD, and Calogero Rivituso, MD

Department of Anesthesiology, Centro Traumatologico Ortopedico, Azienda Ospedaliera Careggi, Firenze, Italy

Address correspondence and reprint requests to Salvatore Sia, Via Santelli, 41, 50134, Firenze, Italy. Address e-mail to sia3{at}interfree.it

We conducted this prospective, randomized study to compare the analgesic effect of femoral nerve block and IV fentanyl administration when given to facilitate the sitting position for spinal anesthesia in patients undergoing surgery for femoral shaft fracture. Five minutes before the placement of spinal block, group FEM patients (n = 10) received a femoral nerve block with lidocaine 1.5% 15 mL, and group IVA patients (n = 10) received IV fentanyl 3 µg/kg. Visual analog scale values during positioning (median and range) were lower in group FEM: 0.5 (0–1) versus 3 (2–6) (P < 0.001). Time to perform spinal anesthesia (mean ± SD) was shorter in group FEM: 1.8 ± 0.7 min versus 3.0 ± 1.1 min (P < 0.05). Quality of patient positioning for spinal anesthesia (0 = not satisfactory, 1 = satisfactory, 2 = good, and 3 = optimal) (median and range) was higher in group FEM: 3 (2–3) versus 1.5 (1–3) (P < 0.005). Patient acceptance was less in group IVA (P < 0.05). In one group IVA patient, an oxygen saturation <90% was recorded during the procedure. We conclude that femoral nerve block is more advantageous than IV administration of fentanyl to facilitate the sitting position for spinal anesthesia in patients undergoing surgery for femoral shaft fractures.

IMPLICATIONS: Femoral nerve block produces a more intense analgesic effect than IV administration of fentanyl when given to facilitate the sitting position for spinal anesthesia in patients undergoing surgery for femoral shaft fractures.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins and Stanford University Libraries' HighWire Press®. Copyright 2004 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2004 by the International Anesthesia Research Society.