Ultrasound-guided genitofemoral nerve block for femoral arterial access gain and closure: a randomized controlled trial

Abstract

ObjectivesThis study aimed to compare the analgesic efficacy and safety of the femoral branch block of the genitofemoral nerve (FBB) versus local infiltration anesthesia (LIA) for femoral arterial access gain and closure.MethodsEighty-two patients (age, 64.8 & PLUSMN; 10.9 years; female, 30.5%) undergoing endovascular procedures using 5-Fr femoral sheath were assigned to either FBB (n = 41) or LIA (n = 41). In both groups, 2% lidocaine HCL with 1:100,000 epinephrine was used as an anesthetic solution. Pain scores during access gain and closure were evaluated using a visual analog scale (score 0-10), patient satisfaction levels with the quality of anesthesia were scored on a 7-point Likert scale, and adverse events were recorded.ResultsThe primary endpoint, pain scores during access closure, was significantly lower in the FBB group than in the LIA group (0.1 & PLUSMN; 0.37 vs 1.73 & PLUSMN; 0.92; p < 0.001). The FBB group also had significantly lower pain scores during access gain compared to the LIA group (0.83 & PLUSMN; 0.83 vs 2.78 & PLUSMN; 1.26; p < 0.001). There was an inverse relationship between pain scores and FBB after adjustment for age, gender, and body mass index (p < 0.001). FBB group reported significantly higher satisfaction with anesthesia quality compared to the LIA group (6.49 & PLUSMN; 0.64 vs 4.05 & PLUSMN; 1.05; p < 0.001). No complications were recognized in either group.ConclusionsUltrasound-guided genitofemoral nerve blocks offered better acute pain relief and higher patient satisfaction than LIA during femoral arterial access gain and closure.