Femoral Rami Obturator Nerve Trunk (FRONT) Block in Intramedullary Nail Surgery .
South Valley University
60 participants
Nov 1, 2025
INTERVENTIONAL
Conditions
Summary
The study propose that using femoral rami obturator nerve trunk(FRONT) block may help postoperative analgesia in nail femur surgeries. The technique is relatively new, introducing one needle to target two nerve blocks in the same entry point. The block spare motor fibers of femoral nerve so it may help both early mobilization and effective analgesia, which in turn enhance early recovery and better outcomes.
Eligibility
Inclusion Criteria3
- the elderly age≥60 years
- American Society of Anesthesiologists (ASA) classification 1-2
- patients who undergoing surgery for intramedullary nail surgery.
Exclusion Criteria4
- patient refused to participate and consent
- patients with a history of mild cognitive impairment (MCI), dementia, and delirium
- patients with known preoperative infections (pulmonary infection, urinary infection, and sepsis).
- coagulopathy
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Interventions
ultrasound-guided FRONT block will be performed at the infrainguinal level, targeting the iliopsoas plane. Using the same needle approach, the subpectineal compartment will be also accessed . We will use ultrasound and electrical nerve stimulation guidance (0.4 mA, 0.1 ms, without eliciting a motor response) to avoid direct involvement of the femoral nerve. A total of 40 mL (20 mL for the iliopsoas plane and 20 mL for the subpectineal compartment) of 0.125% plain levobupivacaine will be administered.
Standard postoperative protocol: * IV nalbuphine (6 mg bolus PRN when NRS\>4 ) * IV paracetamol 1g every 6 hours * IV ketorolac 30 mg every 8 hours PRN (NRS \>4)
Locations(1)
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NCT07268911