Fascia Iliaca (FICB) block in the emergency department for adults with neck of femur fractures: A review of the literature

Abstract

Objective: To ascertain the efficacy of fascia iliaca block for providing analgesia for adults with proximal femoral fractures when compared with standard management. The potential for non-medical practitioners to deliver this block was also assessed.

Method: Medline and CINAHL were searched, as were the reference lists from located articles. The title was reviewed and eligibility determined by this and abstract. The full text was then reviewed. A wide range of papers were included. The Cochrane library was also searched as were case reports.

Results: 179 papers were identified, of which 12 were included for review after eligibility sorting and removal of duplicates. These comprised 2 randomised control trials, an audit, a literature review, 5 cohort studies, NICE guidelines and an interventional uncontrolled trial. The Cochrane library revealed no studies that met the search criteria. 2 case reports detailing adverse outcomes were identified. All papers showed FICB to have a similar or greater efficacy to systemic treatment, with fewer adverse side effects.

Conclusions: FICB is an effective method of providing analgesia in these patients without the undesirable side effects of systemic opioids. Non- medical practitioners are capable of administering this block.

Keywords: Anaesthetic; Analgesia; FICB; Fascia iliaca; Femoral; Non-medical; Practitioner.