Bloc ilio-facial écho guidé aux urgences : Efficacité et sécurité

Abstract

INTRODUCTION: Hip and femoral shaft fractures are extremely painful injuries, usually occurring in elderly, multimorbid patients who are vulnerable to opioids. In this context ultrasound-guided locoregional analgesia (LRA) could be an interesting alternative. AIM: To study pain variation (Delta numerical scale) in hip and thigh trauma patients treated with ultrasound-guided Fascia Iliaca block (FIB) in the emergency department. METHODS: We conducted an observational study over a period of 10 months, including all patients aged 16 and over, who consulted us for isolated hip or thigh trauma, in whom the numeric rating scale (NRS) could be assessed. The primary endpoint was a significant reduction in pain (ΔNRS ≥2). Secondary endpoints were local or general complications and the use of rescue analgesia. RESULTS: Forty-two patients were included. Mean age was 66±17 years, with a sex ratio of 0.9. The mean initial NRS was 9.12±1.3. Mean NRS value was 5.6 at 30 minutes and 3.9 at 120 minutes. Eighty-five percent of patients had a significant reduction in pain after 30 minutes of IFB, and six patients required rescue analgesia with morphine. No adverse effects were recorded. CONCLUSION: Ultrasound-guided FIB can be safely performed by emergency physicians in an emergency department, after appropriate training in the technique.