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The fascia iliaca block (FIB) is an anterior approach to block the lumbar plexus. It disturbed mainly to the anterior region of the thigh by blocking the femoral nerve (LFC) and the lateral femoral cutaneous nerve. Moreover, FIB may possibly be extended to the obturator, ilioinguinal, genitofemoral, lateral cutaneous nerve of the thigh and over the psoas muscle but, rarely reaches the lumbar plexus.
The fascia iliaca compartment could be detected by bony landmarks palpation and the loss of resistance technique. Feeling two tactile ''pops'' due to loss of resistance occurred during the needle passage through the fascia lata and the fascia iliaca. Ultrasound (US) guidance of FIB will increase the success rate and the efficacy of sensory blockade by decreasing the needed local anesthetic amount.
This study was conducted to demonstrate the success incidence (to evaluate the efficacy) of preoperative 0.25% bupivacaine FIB as a sole anesthetic technique in thromboembolectomy of unilateral chronic lower limb ischemia compared to neuraxial anesthesiaas a primary goal. Intraoperative hemodynamics variation, postoperative pain score, total analgesic rescue requests and the total amount of systemic rescue analgesia used in the first postoperative day in addition to any detected postoperative complications were secondary goals. The hypothesis is that; FIB will provide adequate anesthesia as neuraxial anesthesia.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Fascia iliaca block (FIB) | Experimental | ultrasound-guided Fascia iliaca block |
|
| Spinal anesthesia | Placebo Comparator | Spinal anaesthesia using 2 ml hyperbaric bupivacaine 0.5% |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Fascia iliaca block (FIB) | Drug | ultrasound-guided Fascia iliaca block |
| |
| Measure | Description | Time Frame |
|---|---|---|
| The proportion of the patients who did not require conversion to general anesthesia | for 30 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative pain | The post-operative pain will recorded using 10-point Visual Analog Scale (VAS) | For 24 hours after the intervention |
| Heart rate | changes in Heart rate |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Reem A Elsharkawy, MD | Lecturer of Anesthesia and Surgical Intensive Care | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Mansoura University | Al Mansurah | DK | 050 | Egypt |
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| ID | Term |
|---|---|
| D000775 | Anesthesia, Spinal |
| ID | Term |
|---|---|
| D000765 | Anesthesia, Conduction |
| D000758 | Anesthesia |
| D000760 | Anesthesia and Analgesia |
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| Spinal anesthesia |
| Other |
Spinal anaesthesia using 2 ml hyperbaric bupivacaine 0.5% |
|
| For 6 hours after the intervention |
| mean arterial pressure (MAP | changes in mean arterial pressure (MAP | For 6 hours after the intervention |
| hypotension | Incidents of hypotension | For 24 hours from the block |
| Any observed adverse effects | ny adverse effects will be observed over the 24 hours postoperative for local skin hematoma ,sensory deficits or local bleeding | over the 24 hours postoperative |
| bradycardia | Incidents if bradycardia | For 24 hours from the block |