الفهرس 
Aim of the studyOnly 14 pages are availabe for public view
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Abstract
Traumatic femoral fractures often lead to substantial
postoperative pain, a common trigger for emergence agitation in
pediatric patients. Various analgesic approaches, including lumbar
plexus nerve block, femoral nerve block, Fascia iliaca compartment
block, spinal anesthesia, and epidural anesthesia, have been suggested
for managing pain associated with lower limb surgery.
The efficacy of femoral nerve block (FNB) in adults and
children with femoral shaft fractures is extensively documented,
offering a means to decrease reliance on intravenous opioids and
enabling pain-free transportation, examination, and application of
casts or splints.
As peripheral nerve block techniques advance, the fascia iliaca
compartment block (FICB) has become increasingly utilized for
postoperative pain relief in hip, femoral bone, and knee surgeries. This
method, known for its simplicity, cost-effectiveness, and efficacy,
serves as a valuable analgesic approach for femoral fractures
Aim of work:
This study aimed to evaluate the analgesic effects of femoral
nerve block vs fascia iliaca compartment block in traumatic femur
fracture repair in the pediatric population.
To elucidate this aim, 3 equal parallel groups were randomly assigned
to either:
Control group, Fascia Iliaca compartment block group, and
femoral nerve block group. Each contains 30 patients.
Summary
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The main results:
In the current study, there was no statistically significant
difference between the three studied groups regarding age, sex, and
weight.
There was no statistical difference between the FNB group and
the FICB group regarding intraoperative HR at 5,20,45,60.75,90
minute time intervals.
There was a statistical difference between the FNB group,
control group, and FICB group regarding post-operative HR at 30min,
60min, 90min, and 2hrs.4hrs, 6hrs minutes time interval.
There was a statistical difference between the FNB group,
control group, and FICB group regarding intra-operative MAP at
5,20,45,60.75,90 45-minute intervals.
There was a statistical difference between the FICB group,
FNB, and control group regarding post-operative MAP at 30min,
60min, 90min, and 2hrs.4hrs, 6hrs minutes time interval.
As regards anesthetic consumption intraoperative fentanyl
consumption was significantly lower in the FICB group than FNB
group and in the control group.
As regards post-operative 24hrs pethidine dose was statistically
significantly lower in both the FICB group and FNB group than the
control group.
Post-operative 24hrs pethidine dose was lower in the FICB
group than the FNB group but not statistically significant.
As regards first-call rescue analgesia was statistically
significantly higher in both the FICB group and FNB group than the
control group.
Summary
70
First-call rescue analgesia was higher in the FICB group than
the FNB group but not statistically significant.
There was no statistically significant difference between the
three studied groups regarding postoperative complications.
There was a statistical difference between the FICB group,
FNB, and control group regarding post-operative FLACC at 30min,
60min, 90min, 2hrs.4hrs, 6hrs minutes time interval.
Conclusion
o FICB provides better postoperative pain control compared with
FNB following traumatic femur fracture in the pediatric
population.
o However FICB had less nausea, bradycardia, hypotension, and
hematoma but there was a non-significant difference between it
and FNB.
o FICB is also a simple, effective, and noninvasive analgesia for
postoperative pain of femur fractures. FICB is better than FNB in
the duration of anesthesia and block and pain scores.
o FNB analgesia also is an easy and safe technique and improves
pain in postoperative femur fracture.
Recommendation:
o Use of FICB as a regional anesthetic technique alternative to FNB
in pediatrics undergoing femoral fracture repair surgeries as it
provides better post-operative pain control with a wider range of
sensory blocks in the lower limb, and less post-operative opioid
use.
Summary
71
o It is now important to move forward into the area of prevention
and to more aggressive treatments for high-risk groups in pediatric
patients with traumatic femur fractures.
o Further studies should be done with longer follow-up periods,
larger sample sizes, and control groups.
o Further investigations regarding times of injection, the use of and
adjuvant agents, should be accomplished.
o Further study to determine the optimal effects of this regional
block on such patients by checking the success rate of FICB and or
FNB.
o FICB is better than FNB in control of postoperative pain in
traumatic femur fracture repair in the pediatric population and pain
score.
Future perspectives
In the future, research endeavors should focus on
comprehensive analyses to discern intra-institutional and regional
practice trends, alongside extensive retrospective and prospective
studies on pediatric cohorts undergoing treatment for femur fractures.
Such investigations would contribute significantly to advancing our
understanding of optimal management strategies in this population.