Evaluation of haemodynamic stability with the fascia iliaca compartment block in the elderly undergoing hip surgeries

BACKGROUND AND AIMS: Elderly patients with hip fracture have a high anaesthetic risk. Peri-operative management poses a challenge requiring a multi-disciplinary approach. This study investigated whether the fascia iliaca compartment block (FICB) with general anaesthesia (GA) using a supra-glottic device (SGD) can provide adequate analgesia and peri-operative haemodynamic stability and avoid post-operative complications. METHODS: This prospective observational cross-sectional study was conducted after Institutional Review Board clearance and written informed consent of 30 patients of the American Society of Anesthesiologists grade II and III, undergoing elective surgery for fracture neck femur fracture, were obtained. After pre-medicating patients with inj. Glycopyrrolate and Midazolam, ultra-sonography (USG)-guided FICB was given in the supine position with a high-frequency linear probe using 30 ml of 0.25 % bupivacaine with 8 mg dexamethasone. After confirming the effect of the block at 20 min, patients were given GA with inj. Propofol and proper size I-gel was placed, and patients were maintained on oxygen, nitrous oxide, and sevoflurane. RESULTS: FICB with GA using an SGD provides peri-operative haemodynamic stability with minimal changes in mean blood pressure and a heart rate with p value < 0.05. The visual analogue scale (VAS) score before giving the block was 9.5 ± 0.5, which decreased to 2.7 ± 0.49 at 20 min after giving the block, which was statistically significant. The post-operative duration of analgesia was 456 ± 43.438 min. CONCLUSION: Elderly patients with fracture neck femur often have one or more co-morbidities. In such patients, FICB with GA using an SGD is a useful technique providing peri-operative haemodynamic stability and satisfactory post-operative analgesia.