A Comparative Study to Assess the Analgesic Efficacy of Ultrasound Guided Fascia Iliaca Compartment Block versus Femoral Nerve Block for Positioning for Subarachnoid Block in Proximal Femur Fracture

Background: Proper pain control before subarachnoid block (SAB) is must in proximal femur fractures as patients cannot tolerate movement due to severe pain. This study compares ultrasound-guided fascia iliaca compartment block (USG-FICB) with femoral nerve block (USG-FNB) for pre-SAB analgesia. Materials and Methods: Ninety patients scheduled for elective femur fracture surgery under SAB were randomly divided. Group FICB received 25 ml of 0.25% bupivacaine and Group FNB got 15 ml. Pain was assessed using Numerical Rating Scale (NRS) scale. Time for first rescue dose, side effects, and patient satisfaction also noted. Results: Both groups had similar baseline NRS. Group FICB showed faster pain relief and better positioning comfort during SAB (NRS 3.00 vs. 4.28 P = 0.001). Time to first rescue analgesia was more in FICB (4.67 vs. 2.71 h P = 0.001). Satisfaction scores were also higher. Hemodynamics stayed stable, and adverse events were rare. Conclusion: USG-FICB is more effective than USG-FNB in controlling pain before SAB in femur fracture surgery.