Comparison of the Analgesic Effect of Ultrasound-Guided Suprainguinal Fascia Iliaca Block (SIFI) Versus Femoral Nerve Block (FNB) for Positioning During Central Neuraxial Block in Patients Undergoing Proximal Femur Fracture Surgery: A Double-Blinded Randomized Controlled Trial

This study is a double-blinded, randomized controlled trial on proximal femur fracture patients after ethical clearance and informed consent. Patients are randomized into two groups (SIFI block vs. femoral nerve block) using computer-generated numbers and sealed envelopes. A thorough preoperative evaluation, investigations, and counseling regarding the procedure are performed. Standard fasting guidelines and prophylactic medications are followed.

Intraoperatively, patients are monitored with ASA standard monitors, and baseline parameters are recorded. Group A receives an ultrasound-guided suprainguinal fascia iliaca block with 30 ml 0.2% ropivacaine + dexamethasone, while Group B receives an ultrasound-guided femoral nerve block with 20 ml 0.2–0.25% ropivacaine + dexamethasone. Pain (NRS) and hemodynamic parameters are assessed up to 20 minutes post-block. Rescue fentanyl is administered if NRS >4.

Central neuraxial blockade follows: an epidural catheter is placed at L2/L3 and tested with lignocaine-adrenaline, followed by spinal anesthesia at L3/L4 using 0.5% heavy bupivacaine. Adequate analgesia (paracetamol) and hemodynamic stability are ensured. Post-surgery, patients are shifted to HDU for monitoring and pain management.