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Master Thesis

Description de l'intérêt du bloc ilio-fascial dans l'analgésie multimodale des fractures isolées du fémur en médecine de montagne‎ : étude rétrospective observationnelle à partir d'un questionnaire de patients pris en charge par une équipe de médecins correspondants du SAMU de Haute-Savoie

Abstract : Introduction: Isolated femur fracture is a painful injury frequently occurring on ski slopes. Administering fascia iliaca compartment block (FICB), combined with a co-analgesic with intravenous drugs is recommended. Few studies exist on FICB procedures performed by non-anesthesist specialists and none have been conducted on the procedure when performed in a hostile environment. Methods: A single-center retrospective cohort study was performed throughout the 2010-2012 winter seasons. We identified that 82 isolated femur fractures had occurred in 30 ski resorts located in the Haute-Savoie region in France. In most cases pre-hospital sedation was performed by non-anesthesits doctors following a protocol combines intravenous administration of morphin/ketamin and a FICB. Subsequently, patients were sent questionnaires to rate the level of pain at each step of the protocol. Results: 36 patients were included. The average age was 36.1 years. 72% had a FICB. Among patients who had FICB, 27% had severe pain (NS ≥ 7) at mobilization and 24% while undressing. Among patients who did not have FICB, 60% had severe pain at mobilization and 40% at undressing. The average NS of patient who had FICB was 4.4 during mobilization, 3 during transport and 4.4 during undressing. For patients without FICB, had a pain score of 6.5 during mobilization, 4 when transported and 6.9 during undressing. Conclusion: Sedation seems to be superior when combined with FICB. These results are in accordance with previously published studies. This real life study supports the promotion of FICB. A prospective cohort study could be necessary to validate this sedation protocol.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-00842275
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Submitted on : Monday, July 8, 2013 - 12:27:25 PM
Last modification on : Tuesday, May 11, 2021 - 11:36:17 AM
Long-term archiving on: : Wednesday, April 5, 2017 - 8:10:24 AM

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  • HAL Id : dumas-00842275, version 1
  • PPN : 170517101

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Aude Mélin. Description de l'intérêt du bloc ilio-fascial dans l'analgésie multimodale des fractures isolées du fémur en médecine de montagne‎ : étude rétrospective observationnelle à partir d'un questionnaire de patients pris en charge par une équipe de médecins correspondants du SAMU de Haute-Savoie. Médecine humaine et pathologie. 2013. ⟨dumas-00842275⟩

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