Jornal de Ensaios Clínicos
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A Comparison of Ultrasound-guided 3-in-1 Femoral Nerve Block Versus Parenteral Morphinesulfate for Pain Management in Fractured Femur in Emergency Departement

Damon Taherzadeh, Fatemeh Jahanian, Hosein Montazer, Farzad Bozorgi, Hamed Aminiahidashti, Mohammad Hosseininejad and Iraj Golikhatir

Purpose: Safe and effective provision of pain management is one of an essential part and primary goal of initial emergency management of fractured femur in ED. This prospective study was performed to compare the analgesic effects of femoral nerve block (FNB) with parenteral morphine sulfate in patients with fractured femur.

Methods: 40 patients fractured femur were randomized into two groups. The FNB group received 15 ml lidocaine 2% under ultrasound-guided three-in-one, morphine group received 0.1 mg/kg IV morphine sulfate. VAS, were compared during foot dorsi-flexion 15, 30, 60 and 90 minutes later. Resident assistant were advised to prescribe morphine to target a 50% reduction in pain or per-patient request.

Results: There were significant pain relief in FNB according to pain scores (VAS) 15, 30, 60 and 90 minutes after FNB (P<0.001). There was no difference in adverse events between groups.

Conclusion: Ultrasound-guided femoral nerve block able to benefit over IV morphine sulfate for patient with femoral fracture in ED and can provide significant pain relief. Furthermore, standard pain management with parenteral opioids alone provided ineffective pain control in our study.