COMPARATIVE STUDY OF ERECTOR SPINAE PLANE BLOCK VERSUS SYSTEMIC ANALGESIA FOR INTERLOCKING NAIL IN INTERTROCHANTERIC FRACTURE OF FEMUR: A RANDOMIZED CONTROLLED INTERVENTIONAL STUDY

Abstract

Objective: The geriatric population is prone to multiple comorbidities, and their fragile bones and unsteadiness make them susceptible to fractures, commonly observed in the wrist and proximal end of the femur. Internal fixation of fractures under central neuraxial block allows for early mobilization. However, the presence of comorbidities in elderly patients puts them at higher risk for anesthesia and surgery. Methods: To manage postoperative pain following surgery for proximal femur fracture, opioid-sparing multimodal analgesia techniques are employed. Regional anesthesia techniques such as fascia iliaca block, femoral nerve block, and quadratuslumborum block are utilized as part of a multimodal approach. Pain is subjective, and the inability to communicate does not negate the need for appropriate pain relief. Results: Postoperative pain, if poorly managed, can result in complications, prolonged recovery, and chronic pain with reduced quality of life. Effective pain relief enhances patient satisfaction, reduces hospital stays and costs. Inadequate pain control activates the sympathetic nervous system, increases hormonal response, and contributes to adverse events. Opioids, though common, pose risks and adverse effects. Conclusion: The erector spinae plane block (ESPB) is a safe and easy-to-perform technique for postoperative pain management. It involves ultrasound-guided deposition of local anesthetic, allowing effective spread. Previous studies have shown its effectiveness for thoracic pain relief. This study evaluated lumbar ESPB and compared it with systemic analgesics in terms of ease of positioning and postoperative pain control.