$Illustration comparing pain relief in hip fracture with nerve blocks.$

Easing Hip Fracture Pain: Is a Fascia Iliaca Block Better Than a Femoral Nerve Block?

Elliot Brynn in Health & Wellness December 2025 • 4 min read.

"A new study compares two nerve blocks for pain relief during hip fracture surgery prep."

Hip fractures are a common and serious injury, especially among older adults. When someone breaks their hip, getting them ready for surgery often involves a procedure called a subarachnoid block (SAB). This numbs the lower body, but positioning a patient with a hip fracture for this procedure can be incredibly painful. Doctors often use strong painkillers like opioids, but these can cause unwanted side effects, especially in elderly patients who may already have other health issues.

To tackle this challenge, doctors have been exploring nerve blocks, specifically the fascia iliaca compartment block (FICB) and the femoral nerve block (FNB). These blocks use local anesthetics to numb the nerves in the hip area, reducing pain and the need for high doses of opioids. While both techniques have shown promise, a recent study directly compares their effectiveness in easing pain during positioning for SAB.

This article dives into the findings of that study, exploring whether FICB or FNB provides better pain relief, improves the ease of positioning, and enhances the overall experience for patients undergoing hip fracture surgery. Understanding these nuances can lead to improved pain management strategies and better outcomes for individuals facing this challenging injury.

FICB vs. FNB: Which Block Provides Superior Pain Relief?

Illustration comparing pain relief in hip fracture with nerve blocks.

The study, published in the Kathmandu University Medical Journal, directly compared FICB and FNB in patients undergoing proximal femoral fracture fixation. Researchers aimed to determine which block was more effective in reducing pain associated with positioning for a subarachnoid block. Thirty patients were divided into two groups: one receiving FICB and the other receiving FNB.

In the FICB group, patients received an injection of 30 ml of 1.5% lignocaine with adrenaline into the fascia iliaca compartment. The FNB group received 15 ml of the same solution injected around the femoral nerve. Visual analog scale (VAS) scores, which measure pain intensity, were recorded before the block and during positioning for SAB. Time taken to perform SAB, quality of positioning, and patient acceptance were also assessed.

VAS Scores: The FICB group reported significantly lower pain scores during positioning for SAB compared to the FNB group (1.0±1.1 vs. 2.1±0.8; P<0.05).
Time to Perform SAB: The FICB group also had a shorter time to perform SAB (109.6±28.2 seconds vs. 134.8±31.9 seconds; P<0.05).
Quality of Positioning: While the quality of patient positioning was comparable between the groups, patient acceptance was higher in the FICB group (P<0.05).

These results suggest that FICB provides better analgesia and facilitates optimal positioning for subarachnoid block in patients undergoing proximal femoral fracture fixation. The improved pain relief and ease of positioning associated with FICB can contribute to a more comfortable and efficient procedure for both patients and medical staff.

The Takeaway: FICB as a Preferred Option

Based on the findings of this study, fascia iliaca compartment block appears to be a more effective analgesic technique than femoral nerve block for patients undergoing subarachnoid block prior to hip fracture surgery. The reduced pain scores, shorter procedure time, and improved patient acceptance make FICB a valuable tool in optimizing patient comfort and procedural efficiency. However, the study also notes limitations such as the use of landmark techniques instead of ultrasound guidance, suggesting areas for further research and refinement of these pain management strategies.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.3126/kumj.v13i2.16789, Alternate LINK

Title: Analgesia Before Performing Subarachnoid Block In The Sitting Position In Patients With Proximal Femoral Fracture: A Comparison Between Fascia Iliaca Block And Femoral Nerve Block

Subject: General Medicine

Journal: Kathmandu University Medical Journal

Publisher: Nepal Journals Online (JOL)

Authors: A. Ghimire, B . Bhattarai, S. Koirala, A. Subedi

Published: 2017-02-25

Everything You Need To Know

1

What is the difference between a fascia iliaca compartment block (FICB) and a femoral nerve block (FNB)?

A fascia iliaca compartment block (FICB) is a regional anesthesia technique where a local anesthetic is injected into the fascia iliaca compartment, numbing the nerves that supply the hip and thigh. The femoral nerve block (FNB) is another regional anesthesia technique where the anesthetic is injected around the femoral nerve. Both techniques aim to reduce pain, but the study found that the FICB was more effective for pain relief during the subarachnoid block (SAB) positioning in the context of hip fracture surgery.

2

Why are the study findings about fascia iliaca compartment block (FICB) important?

The study's findings are important because they suggest that using the fascia iliaca compartment block (FICB) can lead to better pain management for patients with hip fractures. It showed that patients who received FICB reported significantly lower pain scores during positioning for the subarachnoid block (SAB) compared to those who received the femoral nerve block (FNB). This is significant because it can lead to reduced opioid use, fewer side effects, and a more comfortable experience for the patient. The improved quality of positioning, time to perform SAB and patient acceptance also contributes to a more efficient surgical process for the medical staff.

3

What are the potential implications of using a fascia iliaca compartment block (FICB) instead of a femoral nerve block (FNB)?

The implications of using fascia iliaca compartment block (FICB) over femoral nerve block (FNB) are considerable for patients undergoing hip fracture surgery. A more effective pain management approach, such as FICB, could mean less reliance on strong painkillers like opioids, potentially reducing the risk of side effects such as nausea, constipation, and respiratory depression, especially in elderly patients. This translates into a better overall experience for the patient, improving their comfort and potentially aiding in their recovery process. For the medical staff, a shorter procedure time and better patient acceptance, as noted with the use of FICB, could lead to a more efficient surgical process and improved patient outcomes.

4

How were Visual Analog Scale (VAS) scores used in the study?

The Visual Analog Scale (VAS) scores were used in the study to measure the pain intensity reported by patients before and during the positioning for the subarachnoid block (SAB). The study found that the patients who received a fascia iliaca compartment block (FICB) had significantly lower VAS scores compared to those who received a femoral nerve block (FNB). This indicates that the FICB provided better pain relief. Lower VAS scores signify less pain, thus showcasing the efficacy of FICB in managing pain related to hip fractures during this specific phase of the surgical preparation.

5

What was the main comparison made in this study?

The study compared the fascia iliaca compartment block (FICB) and the femoral nerve block (FNB) techniques. The study found that the FICB group reported significantly lower pain scores during positioning for the subarachnoid block (SAB) compared to the FNB group. The study also found that the FICB group had a shorter time to perform SAB and had higher patient acceptance. This comparison helped to establish that FICB is a more effective analgesic technique than FNB in the context of hip fracture surgery.