Comparative study of the efficacy of ultrasound guided femoral nerve block versus fascia Iliaca compartment block for postoperative analgesia in patients with femur fracture

Abstract

Background: Femur fractures are associated with severe postoperative pain. Ultrasound-guided regional blocks offer effective analgesia with minimal systemic adverse effects. Femoral nerve block (FNB) and fascia iliaca compartment block (FICB) are commonly used, but comparative evidence is limited. Aim: To compare the efficacy of ultrasound-guided femoral nerve block and fascia iliaca compartment block for postoperative analgesia in patients undergoing femur fracture surgery. Methods: This prospective comparative study included 60 patients (ASA I-III) undergoing femur fracture surgery under spinal anaesthesia. Patients were allocated into two groups: Group FNB (n=30) received ultrasound-guided femoral nerve block and Group FICB (n=30) received ultrasound-guided fascia iliaca compartment block using 30 ml of 0.25% bupivacaine. Postoperative pain was assessed using the Numeric Rating Scale (NRS). Hemodynamic parameters and block-related complications were recorded. Results: Demographic variables and surgical characteristics were comparable between groups. Postoperative NRS scores were significantly lower in the FICB group at multiple time intervals. Duration of analgesia was longer in the FICB group. Hemodynamic parameters remained stable in both groups with no statistically significant differences. No major complications were observed. Conclusion: Ultrasound-guided fascia iliaca compartment block provides superior and longer-lasting postoperative analgesia compared to femoral nerve block, with comparable safety and hemodynamic stability.