Simple Manual Pressure with Ultrasound-Guided Femoral Nerve Block: A randomized single blind study

• Published in: The American journal of emergency medicine Vol. 50; pp. 278 - 282
• Main Authors: Sağlam, Caner, Korkmaz, Ayhan, Güllüpinar, Birdal, Gönüllü, Hayriye, Korkut, Semih, Karagöz, Arif, Tandon, Shikha, Ünlüer, Erden Erol
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2021; Elsevier Limited
• Subjects: Adult; Aged; Aged, 80 and over; Analgesia; Analgesics; Anesthetics; Compression; Emergency medical care; Female; Femoral Nerve; Femur; Fractures; Hip; Hip fractures; Hip Fractures - drug therapy; Hip joint; Humans; Joint surgery; Male; Middle Aged; Narcotics; Nerve Block - methods; Nerve blockade; Pain; Pain Management - methods; Pain Measurement; Palliation; Patients; Pressure; Simple compression; Single-Blind Method; Statistical analysis; Ultrasonic imaging; Ultrasonography, Interventional; Ultrasound; Analgesia; Hip fractures; Simple compression; Nerve blockade
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2021.07.063

The aim of this study was to investigate the effect of compression on the Visual Analog Scale (VAS) score following the application of 3-in-1 femoral nerve block (FNB), used for pain palliation in patients with hip fractures. This was a randomized controlled trial study on application of pressure versus no pressure following FNB in patients with hip fractures. Their VAS scores were recorded and an ultrasound-guided 3-in-1 FNB was performed as a standardized procedure. After the procedure, patients were randomized into two groups and a weight with 2 kg pressure was applied to the treated area in one group. After 30 min, VAS scores were recorded again. VAS scores of all patients recorded before and after the procedure, and post-procedural VAS scores of pressure-applied and no pressure-applied groups were statistically compared. 34 patients were included in this study with 17 patients falling in the compression group (group C), and the remaining half in the non-compression group (group NC). The pre-procedural mean VAS scores were 9.35 (95% CI; 8.95–9.76)), while the post-procedural mean VAS scores dropped to 2.35 (95% CI; 1.65–3.06) in group C. The pre-procedural mean VAS score was 9.12 (95% CI; 8.64–9.59), while the post-procedural mean VAS score was 5.06 (95% CI; 4.09–6.03) in group NC. When the average reductions in VAS score following the procedure were compared, the mean difference between the two groups was calculated to be 2.94 (95% CI; 1.69–4.19) which favours group C. This difference was statistically significant (p < 0.001). Our study shows that, the application of simple compression after 3-in-1 FNB in patients with hip fractures provides a significant reduction in VAS scores.