Pain Relief during Positioning for Spinal Anesthesia in patients with Femoral Fracture: A Comparison between Femoral Nerve Block and Intravenous Nalbuphine

Aim: To enlighten better technique in terms of pain relief (on visual analogue scale) during positioning, time to perform spinal anesthesia, the quality of position and acceptance of patients. Design: Interventional Quasi Experimental study Design: Interventional Quasi Experimental study Place and duration of study: This study was conducted in Department of Anesthesia, ICU & Pain Management Sheikh Zayed Hospital Rahim Yar Khan from Jan 2013 to June 2013. Methods: Eighty-four ASA I-II patients aged 18-80 years undergoing surgery for femur fracture under spinal block were selected and randomized into two groups (42 in each group). Fifteen minutes before positioning for spinal block, the FNB group received femoral nerve block with a mixture of 15 ml lignocaine with adrenaline and 5ml distilled water and the IVA group received 6mg intravenous nalbuphine. SPSS 16 was used for statistical analysis. Methods: Eighty-four ASA I-II patients aged 18-80 years undergoing surgery for femur fracture under spinal block were selected and randomized into two groups (42 in each group). Fifteen minutes before positioning for spinal block, the FNB group received femoral nerve block with a mixture of 15 ml lignocaine with adrenaline and 5ml distilled water and the IVA group received 6mg intravenous nalbuphine. SPSS 16 was used for statistical analysis. Results: Pain assessed on visual analogue scale (VAS) during positioning was significantly less in FNB group (1.40 +/- 0.66) versus IVN group (3.02 +/- 1.39), P=0.000. Time to perform spinal block was significantly shorter in FNB group (2.15 +/- 0.78min) versus IVN (3.50 +/-.46min), P=0.001. Quality of patient positioning during spinal was significantly better in FNB group (2.45 +/- 0.55) than IVN group (1.88 +/- 0.80), P=0.000. Acceptance of patient was very significantly higher among FNB group (40/42=95.24%) than IVN (28/42=66.67%) group, P=0.001 Conclusion: The results of this study reflected that femoral nerve block provides better analgesia resulting in adequate positioning, rapid performance of spinal and higher acceptance among patients with femoral fracture during positioning for administration of spinal anesthesia.