Femoral Neck Fractures
Conditions
Brief summary
Falls are a common problem in elderly patients resulting fractured femur, which require early operation. Adequate postoperative pain control will provide good recovery. The investigators will compare the efficacy of postoperative pain control among intrathecal morphine, femoral nerve block, and periarticular infiltration with bupivacaine in patients undergone intramedullary hip screw under spinal anesthesia.
Detailed description
Study methods : Every patients without any exclusion criteria will be performed spinal anesthesia by 0.5% heavy bupivacaine then divided into 4 groups 1. Controlled group : spinal anesthesia alone 2. Femoral nerve block by 20 mL of 0.25% bupivacaine before spinal anesthesia 3. Spinal anesthesia plus 0.1 mg morphine intrathecally 4. Spinal anesthesia plus periarticular infiltration with 20 mL of 0.25% bupivacaine All patients will receive postoperative intravenous patient controlled analgesia (IV PCA) morphine for 48 hours. Data collection 1. Demographic data 2. Pain score : preoperative, 3 hours postoperative in the 1st six hours, 12 hours postoperative by visual analog scoring system (VASS) 3. Patient global assessment and patient satisfactory VASS at 24 and 48 hours postoperative 4. The amount of morphine at 24 and 48 hours postoperative and the time of the 1st dose
Interventions
1.8-2.5 mL of 0.5% heavy bupivacaine for spinal anesthesia 20 mL of 0.25% bupivacaine for femoral nerve block 0.1 mg of intrathecal morphine 20 mL of 0.25% bupivacaine for periarticular infiltration
Sponsors
Study design
Eligibility
Inclusion criteria
* 18-90 years old * good consciousness, well co-operated, can use PCA machine * ASA class 1-3 * no contraindication of spinal anesthesia * accept for spinal anesthesia * body weight \> 30 kg * BMI 20-35 kg/m2 * no history of research-drug allergy
Exclusion criteria
* previous history of hip surgery (the same side) * pathological fractured such as severe infection, bone cancer
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The amount of morphine consumption. | 24 hours postoperative |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Efficacy of pain control | 48 hours postoperative | Efficacy of pain control measured by 1. The amout of morphine consumption 2. Visual analogue pain scale 3. Patient satisfaction by patient global assessment 4. Incidences of adverse events : nausea, vomiting, pruritus |
Countries
Thailand