الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Fractures of the femur are common orthopedic emergencies presenting to emergency departments (ED). These patients need effective analgesia as part of their initial management. In spite of the guidelines of the College of Emergency Medicine, there is sometimes reluctance to give adequate analgesia to these patients especially in elderly, frail patients and patients with concurrent head or chest injury.
Nerve blocks in femoral fracture patients can be achieved using different techniques. The use of ultrasound for nerve block was first reported in 1978 by La Grange and colleagues who performed supraclavicular brachial plexus blocks using a doppler ultrasound for detection of blood flow to identify blood vessels and inject local anesthetic in their vicinity aiming to block the accompanying nerves.
Traditionally, only anesthesiologists performed US-guided regional anesthesia (UGRA). In recent years, though, emergency physicians have been adopting this technique. However, in Egypt, a lack of evidence exists on emergency physician-performed UGRA in proximal femoral fracture patients.
The aim of this study was to evaluate the effectiveness of adding US-guided FNB to multimodal analgesia in terms of safety, success rate, onset, duration and patient’s satisfaction in patients with femur fractures in the Emergency Department.
Fifty patients were enrolled then assigned randomly into 2 groups. Control group received paracetamol )1000 mg IV every 6 hours), ketorolac )30 mg IV every 6 hours (and bolus doses of fentanyl when pain score > 4. FNB group received the same analgesia plus US-guided FNB.