Ultrasound-guided femoral nerve blocks are not superior to ultrasound-guided fascia iliaca blocks for fractured neck of femur

100 patients with proximal femoral or neck of femur fractures were randomized to receive an active femoral nerve block (FNB) or a fascia iliaca compartment blockade (FICB) for the reduction of pain. Both blocks were administered: the active block contained 20mL of 0.5% levobupivacaine and the placebo block contained 20mL of normal saline. Outcomes of interest included pain relief, measured as the reduction on an 11pt verbal pain scale (or PAINAD for cognitively impaired patients), and the incidence of blockade failure. Follow up was performed at 20 minutes following administration of the final block. Results revealed no significant difference in pain score reduction between the FNB and FICB groups, even when adjusting for cognitive ability and timing of block administration. The incidence of blockade failure was similar in both groups.