Ultrasonography-guided articular branch of femoral nerve and anterior obturator nerve block for perioperative pain in hip surgery

Background: We present a novel block of the articular branch of the femoral nerve (ABFN) and anterior obturator (AO) nerve for perioperative analgesia during various hip surgeries. Materials and Methods: In this prospective audit, 30 patients underwent hip surgeries such as hemiarthroplasty, percutaneous femoral nailing, and dynamic hip screwing performed by the same surgeon under subarachnoid block (SAB) that was performed by the same anesthesiologist using 10–15 mg of bupivacaine 0.5% (heavy). Pain management after hip surgery used to be provided by using epidural analgesia or intravenous (IV) analgesia. During this study, we performed ultrasonography (USG)-guided block to ABFN and AO with injection ropivacaine (0.2%) 35 mL (20 + 15 mL) with 8 mg dexamethasone just before spinal anesthesia in operation theatre. Pain scores were compared using Numeric Pain Rating Scale at pre-procedure, followed by 0, 4, 8, and 12 h after the block and the requirement of first dose of IV analgesics. Results: Pain scores were significantly lower in these patients in the first 12 h of the surgery along with less requirement of IV analgesics. The onset of blocks start within 3–5 min, and patients were more comfortable in sitting position while performing SAB. Discussion: Blocking ABFN and AO nerve provides superior analgesia during perioperative period in hip surgeries and decreases the requirements of IV analgesics and provides effective analgesia in patients while performing SAB in sitting position.