Background and objectives
Postoperative pain relief is crucial in elderly, however, the use of opioids is limited owing to their potential side effects. We studied the effects of patient-controlled ultrasound guided fascia iliaca compartment block (FICB) with Levobupivacaine versus patient-controlled intravenous fentanyl on postoperative pain score in patients scheduled for fixation of femur fractures under general anesthesia.
Methods
60 patients ASA physical status I and II undergoing elective fixation of fracture femur were enrolled in this randomized study into two groups. patients received fentanyl 20µg/ml solutions through a PCA pump programmed to give a basal infusion of 10µ/h and bolus doses of 2ml/dose with a 15min lockout interval. PCA was adjusted to deliver a continuous basal infusion of 4ml/h levobupivacaine 0.125% and 2ml demand boluses with a lockout interval of 15min. Visual analogue score (VAS) and total postoperative rescue analgesic consumption were assessed.
Results
VAS scores were significantly lower in PC-FICA group compared to PC-IVF group at 1h, 3h and 6h postoperative. 7 patients requested post-operative rescue analgesia in PC-FICA group compared to 19 patients in PC-IVF group. Total consumption of rescue analgesia was significantly decreased in PC-FICA group (31.4 ± 10.7mg) compared to PC-IVF group (70.5 ± 20.4mg) (P< .05).
Conclusion
PC-FICA provided a better quality of analgesia and decreased postoperative rescue analgesic requirement without increased side effects compared to PCA IV fentanyl.