Ultrasound-guided Suprainguinal Fascia Iliaca Block for Postoperative Analgesia in Patients Undergoing Femur Fracture Surgery: A Randomized Control Trial Study Comparing Bupivacaine (0.25%) and Bupivacaine (0.125%).

BACKGROUND

Ultrasound-guided supra-inguinal fascia iliaca compartment block (FICB) is increasingly used for postoperative analgesia in femur fracture surgery. However, evidence comparing different concentrations of bupivacaine for this block remains limited.

OBJECTIVE

The objective of this study is to compare the analgesic efficacy and safety of 0.25% and 0.125% bupivacaine administered through ultrasound-guided supra-inguinal FICB in patients undergoing femur fracture surgery.

MATERIALS AND

METHODS

In this prospective, randomized, double-blind controlled trial, 90 American Society of Anesthesiologists I-II patients aged 18-50 years undergoing elective femur fracture fixation under spinal anesthesia were enrolled. Patients were randomized into two groups: Group A (n = 45) received 20 mL of 0.25% bupivacaine and Group B (n = 45) received 20 mL of 0.125% bupivacaine for ultrasound-guided supra-inguinal FICB. Postoperative pain scores, rescue analgesic requirements, hemodynamic parameters, sensory blockade, ambulation, and adverse events were assessed.

RESULTS

Baseline characteristics were comparable between the groups. Visual Analog Scale scores at rest and during movement 20 min after block administration were significantly lower in Group A (P < 0.001). Postoperative pain scores remained significantly lower in Group A at 2, 4, 6, and 18 h. Patients receiving 0.25% bupivacaine had significantly greater sensory blockade, lower total rescue analgesic consumption, earlier time to first rescue analgesia, and more stable hemodynamic parameters than those receiving 0.125% bupivacaine (P < 0.05). No major complications or adverse effects were observed in either group.

CONCLUSION

Ultrasound-guided suprainguinal FICB is an effective and safe technique for postoperative analgesia in femur fracture surgery. Compared with 0.125% bupivacaine, 0.25% bupivacaine provided superior analgesia, prolonged pain relief, reduced analgesic requirements, and better hemodynamic stability.