Ultrasound-guided Femoral - Sciatic Nerve Block for Lower Limb Long Bone Fractures

Fractures of the long bones in the lower limbs are injuries that cause severe to extremely severe pain, posing risks to the patient's circulation, respiration, and even life. Pain management for patients with lower limb long bone fractures in the emergency department is critically important.

This study aimed to evaluate the feasibility of ultrasound-guided femoral and sciatic nerve blocks in patients with lower limb long bone fractures in the emergency department (ED). The secondary objective was to assess the effectiveness of this procedure as an adjunct to pain management in the ED.

This observational study included 133 ED patients with lower limb long bone fractures who received ultrasound-guided femoral and sciatic nerve blocks (anterior approach). Feasibility was assessed by observing and recording procedural duration, number of attempts, and technical complexity. The effectiveness of pain management was evaluated using the visual analog scale (VAS) at the 5th, 10th, 15th, 30th, 60th, and 120th minutes. Data were gathered and analyzed using SPSS 25.0. Quantitative variables were described using frequencies and percentages, while qualitative variables were presented as mean ± standard deviation. Paired-samples T-tests were used to compare the pain scores at different time points.

The mean age of participants was 54.21 ± 18.43 years (range 18-93), including 76 males and 57 females. The average procedural duration was 4.92 ± 1.51 minutes (range 2.4-8.5). All blocks were successful on the first attempt, with no complications. Post-procedure, pain scores decreased by 53.47% at the 5th minute, 72.73% at the 10th minute (p < 0.001), and 97.25% at 15 minutes (p < 0.001). Pain scores remained stable from 30 to 120 minutes (p < 0.001).

Ultrasound-guided femoral and sciatic nerve blocks (anterior approach) are feasible in the ED. This technique provides significant and sustained pain relief.