Fracture femur is a common injury which is associated with excruciating pain. Positioning for
neuraxial blocks is always challenging because even slight overriding of the fracture ends is
intensely painful .It can causing major patient distress which accompanied by well-known
physiological sequelae such as sympathetic activation causing tachycardia, hypotension, and
increased cardiac work that may compromise high-risk cardiac patients.

Fascia iliaca compartment block is highly effective in blocking lateral cutaneous nerve of
the thigh and femoral nerve. Fascia iliaca compartment block is not only easy to perform but
it is also associated with minimal risk as the local anesthetic is injected at a safe
distance from the femoral artery and femoral nerve. It is always safe to perform the fascia
iliaca compartment block prior to spinal anesthesia as the patient can respond during
administration of the local anesthetic and can prevent intra-neuronal injections