Comparative Effectiveness of Combined Lumbar- Para Sacral Nerve Block and Spinal Anaesthesia on the Pain Intensity and Duration of Anaesthesia in Patients with Tibial Fracture

Abstract

Background: The aim of this study was to evaluate the effect of combined lumbar plexus– para sacral nerve block (LP/NB) and spinal anaesthesia (SA) on the duration and intensity of postoperative pain in patients with Tibia fracture requiring surgery. Methods: In this clinical trial, 40 patients with tibial fractures requiring surgery, who were admitted to a referral hospital in north-eastern Iran from 2020 to 2021, and randomly subjected to LP/NB or spinal anaesthesia. Pain intensity and duration of anaesthesia in the two groups were compared based on a numerical rating scale within 4, 6 and 12 hours from the induction of anaesthesia. Clinical demand for analgesics following surgery was also recorded. Data were statistically analysed with IBM SPSS. Results: The mean age of participants was 37.4 ±14.4, with 29 (72.5%) and 11 (27.5%) male and female patients, respectively. There were no significant differences in age and sex ratio between the two groups. The mean pain intensity within 4 hours from surgery was lower in the LP/NB group, however, this difference was not statistically significant (p-value: 0.054). Likewise, there were also no significant differences between the values reported for 6 (p-value: 0.303) and 12-hour (p-value: 0.523) post-surgery pain intensity for each group. Overall, the mean pain intensity at any given time was not significantly different between the two groups of LP/NB and SA (p-value: 0.671). Conclusion: There was no significant difference between the two groups in terms of mean pain intensity at 4, 6 and 12 hours after the onset of the block. No side effects were observed in any of the patients.