Indian Journal of Anaesthesia

COMMENTS ON PUBLISHED ARTICLE
Year
: 2015  |  Volume : 59  |  Issue : 8  |  Page : 530-

Comparative evaluation of femoral nerve block and intravenous fentanyl for positioning during spinal anaesthesia for surgery of femur fracture


Dinabandhu Patra 
 Department of Anesthesia, Trauma Centre, Ispat General Hospital, Rourkela, Odisha, India

Correspondence Address:
Dinabandhu Patra
Department of Anesthesia, Trauma Centre, Ispat General Hospital, Rourkela, Odisha
India




How to cite this article:
Patra D. Comparative evaluation of femoral nerve block and intravenous fentanyl for positioning during spinal anaesthesia for surgery of femur fracture.Indian J Anaesth 2015;59:530-530


How to cite this URL:
Patra D. Comparative evaluation of femoral nerve block and intravenous fentanyl for positioning during spinal anaesthesia for surgery of femur fracture. Indian J Anaesth [serial online] 2015 [cited 2021 Apr 21 ];59:530-530
Available from: https://www.ijaweb.org/text.asp?2015/59/8/530/163014


Full Text

Sir,

I read with great interest the article 'Comparative evaluation of femoral nerve block and intravenous fentanyl for positioning during spinal anaesthesia'. The authors concluded that femoral nerve block provides better analgesia, patient satisfaction, and satisfactory positioning than intravenous fentanyl for position during spinal anaesthesia in patients of fracture femur. However, I feel that the following points should be considered while doing a femoral nerve block. [1]

The authors in the study used the classic technique of femoral nerve block. Most of the patients included in the study 45/60 (75%) had proximal rather than fracture of distal or shaft of the femur. Three in one femoral block or fascia iliaca block are more effective than a classic femoral block in the proximal femoral fracture as it gives anaesthesia to femoral, obturator and lateral cutaneous nerves which innervates the hip joint. [2] In three-in-one technique of femoral nerve block, application of pressure 2-4 cm below the injection site after administration of the local anesthetic (LA) solution will help in spreading of the LA solution proximally and block the obturator and lateral femoral cutaneous nerve in addition to the femoral nerve and will provide more effective analgesia.

References

1Jadon A, Kedia SK, Dixit S, Chakraborty S. Comparative evaluation of femoral nerve block and intravenous fentanyl for positioning during spinal anaesthesia in surgery of femur fracture. Indian J Anaesth 2014;58:705-8.
2Tam CW, Rainer TH. Femoral nerve block for pain management of femoral fractures in the emergency department: Evidence based topic review. Hong Kong J Emerg Med 2005;12:178-81.