Background: Patient positioning for performing subarachnoid blockade in hip or proximal  femur fracture patients causes extreme pain which may require substantial amount of analgesic for patient cooperation and success of block. This study aimed to  assess the analgesic efficacy of fascia iliaca compartment block (FICB) to alleviate pain during  positioning of spinal anaesthesia in hip or proximal femur fracture patients undergoing surgery. 

Methods: This was a randomized, controlled prospective study. Sixty patients between 18 and 90 years, of either sex, ASA PS I to III posted for hip or proximal femur fracture surgery having pain of numerical rating scale (NRS) more than three. In group I, FICB was given thirty minutes prior to spinal  anaesthesia, whereas group II patients did not receive any block. Injection Fentanyl 1mcg/kg IV was given during  positioning if NRS score was four or more in both groups. Heart rate, SPO2, MAP, NRS at the time of positioning, time to perform spinal anaesthesia, ease of positioning,  and number of rescue analgesia were recorded. 

Results: The mean NRS score was reduced from 7.53 to 2.40 in group I and from 7.07 to 5.40 in group II during  positioning for spinal anaesthesia which was statistically significant (P-value < 0.001). Similarly,  the mean time to perform spinal anaesthesia was 61.57 second in group I and 114.60 second in group II which was statistically significant (P<0.001).

Conclusion: FICB effectively provides analgesia to alleviate pain during positioning for spinal  anaesthesia in patients with hip or proximal femur fracture surgeries. 

Keywords: Fascia iliaca compartment block, Positioning, Proximal femur fracture, Spinal Anaesthesia.