Single fascia iliaca compartment block for pain relief in patients with fractured neck of femur in the emergency department: a pilot study

Abstract

Objectives: Fractured neck of femur (NOF) is a common injury in the elderly, which causes severe pain and distress. Fascia iliaca compartment block using the 'Two Pop Technique' is safe and relatively easy to perform. It has been traditionally performed by anaesthetists in a controlled environment for perioperative pain relief with very good results. The purpose of the study was to investigate its applicability and success rate in a busy emergency department (ED) with changing junior staff and time pressures.

Materials and methods: A prospective cohort study was carried out on 137 patients presenting to the ED with fractured NOF. The blocks were performed by emergency physicians (EPs) of different grades after a short training session. Pain scores (no pain=1, worst pain=10) were documented at presentation, 30 and 60 min after the block.

Results: A reduction in the pain score of three points or more was regarded as a successful block. This was achieved in 77.4% of all documented cases. No adverse events were reported and the participating EP found it very easy to master the technique.

Conclusion: The fascia iliaca compartment block offers a very good, efficient and safe alternative to conventional analgesia in the treatment of pain in patients with fractured NOF. It should be used more by EPs as it is easy to learn and it requires inexpensive equipment.