Ultrasound gui̇ded the comparison of different volumes of local anaesthetics in fascia iliaca compartment block

We aimed to find the most effective volume of local anesthetic for fascia iliaca compartment block (FICB) when applied to patients in order to control post-operative pain in patients undergoing femur and knee surgery. Forty-five patients with ASA physical scores of I-III were randomly included in this study. The anesthesia induction was done by using fentanyl 2 mcg/kg, propofol 2 mg/kg and rocuronium 0.6 mg / kg in patients with whom the pre-operative preparations were completed. Sevoflurane 1.5-2 % for the continuation of anesthesia, rocuronium 0.1 mg/kg for muscle relaxation and fentanyl 1 mcg / kg for analgesia were provided. After the surgical procedure finished, patients were provided FICB with ultrasound guidance without extubation. Patients were randomly divided into 3 groups. Bupivacaine 0.25 % was administered to Group1 0.3 ml/kg, to Group 2, 0.4 ml/kg and to Group 3, 0.5 ml/kg. The patients were sent to their ward after FICB and after extubation. The patients' vital signs for 24 hours, pain scores, diclophenac sodium 75 mg İ.M administration performed and probably adverse effects recorded whom VAS scores are 5 and above. Significantly less additional analgesic was used in postoperative 4.th hour in Group 2 and Group 3 compared to Group 1(p=0,03), also in postoperative 6.th hour in Group 3 compared to Group 1 and Group 2 in terms of the postoperative analgesic requirements (p=0,026). The analgesic consumption in the first 24 hours reduced clinically when the volume of local anesthetics (LA) was increased however no significant difference was found. When the groups were compared in terms of postoperative pain scores, the values at 1.st, 4.th, and 6.th hours in group 1 were significantly higher than in Group 3 (p <0.05). In conclusion, FICB is a highly effective, reliable field block providing postoperative analgesia for femur and knee surgery. In this study, the lowest pain scores and analgesic requirement were obtained in the group that used bupivacaine 0.25% containing 0.5 ml / kg of LA. Key words: Fascia İliaca Compartment Block, Postoperative Analgesia, Ultrasound, Bupivacaine, Peripheral Block, Femur Surgery.