Surgery: Analgesia Surgery Analgesia
Conditions
Interventions
Purpose:
To see whether analgesic efficacy of Fascia Iliaca Compartment Block (FICB) is better than that of Morphine during and post hip fracture surgery
Theoretical framework:
The commonly used nerv
Sponsors
Record Provided by the NHSTCT Register - 2007 Update - Department of Health
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: All adult ASA physical status 1, 2 and 3 patients with hip fracture posted for DHS or cannulated screw fixation
Exclusion criteria
Exclusion criteria: 1. Dementia/confusion as it is difficult to assess pain relief 2. Pre-operative chest infection and/or poor respiratory function - Temperature 380C or more, white cell count> 11000 mm3, Respiratory rate > 25 per minute, auscultation and or chest x-ray evidence, Sp02 < 90 % on air 3. Congestive Cardiac Failure (CCF) 4. Bed bound or use of 2 or more aids for mobilisation pre-fracture 5. Malignancy 6. Coagulopathy 7. Known or suspected allergy to Ropivacaine and/or Morphine 8. Local infection at the site where the block is to be performed 9. Refusal of permission to approach General Practitioner Justification for these exclusion criteria: Pre-fracture poor mental status, poor mobility, CCF, poor respiratory function and malignancy are independent risk factors for poor outcome following hip fracture The morbidity and mortality in this group is high and unlikely to be influenced by choice of technique. The others are standard contra-indications for any nerve block technique.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Total dose of morphine required during first 24 hours post-op | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Time to first dose of morphine post-op 2. Pain scores in recovery room and at 13, 16 and 24 hours post-op, intra- and inter-group analysis 3. Time to first appropriate response to verbal commands post-op 4. Time to discharge from recovery room 5. Occurrence of nausea and vomiting in recovery and no. of episodes during the first 24 hours post-op 6. Total dose of Cyclizine required in the first 24 hours post-op. 7. Need for Granisetron during the first 24 hours post-op. 8. Sedation Scores at 1,3,6 and 24 hours post-op. 9. Mental Test Scores at 1,3,6 and 24 hours post-op. compared to pre-op score, intra- and inter-group analysis. 10. Other: unlikely to find significant difference because of sample size but full reporting of morbidity, complications, rehabilitation outcomes and mortality will be useful. There has been no involvement of patient groups, research participants or communities in the design of this study. | — |
Countries
United Kingdom
Outcome results
None listed