Effectiveness of fascia iliaca compartment block in adult fractured neck of femur patients: An integrative review

Abstract

Introduction: Patients falling and fracturing their hip is a burden on health care facilities and affects both the patients and their families. The purpose of this review is to give perioperative nurses a deeper understanding of regional blocks that may be considered – in particular, the fascia iliaca compartment block. Traditional pain management strategies, such as opioids, have limitations which leads to the use of several different types of regional blocks being administered as an alternative approach to pain relief prior to surgery.

Methods: A thorough search was conducted using CINAHL, MEDLINE and PubMed databases to find relevant papers published in English from 2016 to the present. Primary research studies – namely cohort studies, retrospective and prospective studies, and randomised controlled trials – were integrated to provide a synthesised overview of this topic. A recent systematic review that focussed on delirium was also reviewed to add to this discussion.

Discussion: While this review primarily investigated fascia iliaca compartment blocks, numerous research studies have been cited in this review to demonstrate an overview of the several different types of regional blocks available for fractured neck of femur patients. These include femoral nerve blocks, femoral obturator nerve blocks and pericapsular nerve group blocks as well as fascia iliaca compartment blocks. Some of these are administered by a single injection while others are provided via continuous infusion.

Conclusion: In patients with neck of femur fractures, fascia iliaca compartment blocks have consistently demonstrated success in reducing pain, decreasing the use of opioids, improving patient satisfaction and hastening healing. Although fascia iliaca compartment blocks appear to lower the likelihood of post-operative delirium, more research is needed to definitively determine the long-term cognitive effects. This review places a strong emphasis on the importance of pain treatment being tailored for each individual health care facility and patient.