None listed
Conditions
Brief summary
This study is of pain relief for people with a broken hip (fractured neck of femur) in the period between arriving at the Emergency Department and having an operation. Standard treatment of pain is by injections of morphine as required. This study will look at injecting long acting local anaesthetic to the nerves which supply the hip. An ultrasound machine will be used to accurately place the injection. It is hoped that this will give better pain relief than morphine alone with less side effects of nausea and drowsiness. The local anaesthetic is expected to last about 18 hours. This will cover the period from the Emergency Department to Operating Theatre for many patients. Doctors, Nurses and Patients will not know whether local anaesthetic or a saline placebo has been injected. All patients will be given as much morphine as is necessary to control their pain.
Interventions
Twenty millilitres of long acting local anaesthetic or placebo is instilled around the femoral nerve on the side of the fractured neck of femur. Distal pressure is applied to ensure the local anaesthetic spreads upwards in the fascial plane to involve the obturator nerve and lateral cutaneous nerve of thigh. Ultrasound guidance of the needle is used to ensure accurate injection, while minimising the risk of damage to the nerve or injection of local anaesthetic into the blood vessels. Aseptic tec
Twenty millilitres of long acting local anaesthetic or placebo is instilled around the femoral nerve on the side of the fractured neck of femur. Distal pressure is applied to ensure the local anaesthetic spreads upwards in the fascial plane to involve the obturator nerve and lateral cutaneous nerve of thigh. Ultrasound guidance of the needle is used to ensure accurate injection, while minimising the risk of damage to the nerve or injection of local anaesthetic into the blood vessels. Aseptic technique is used.Patients will receive either 0.5% bupivacaine or normal saline. These will be pre-prepared so that medical and nursing staff and patients will be ‘blind’ as to whether the local anaesthetic or placebo is injected. Bupivacaine is slow acting and therefore does not sting on injection as rapid acting lignocaine does.
Sponsors
Dr James Cameron, FCEM.
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patients with a fractured neck of femur within the past 48 hours presenting to the emergency department with pain or unable to weight bear.
Exclusion criteria
Localised soft tissue infection at site of injury. Coagulopathy due to warfarin or any other cause with an INR greater than 3. Abbreviated Mental Test Score less than 7 out of 10 or patient otherwise without capacity to consent.
Outcome results
None listed