Hip Fractures
Conditions
Brief summary
The goal of this study is to compare the analgesic effect of a blind fascia iliaca compartment block to an ultrasound-guided femoral nerve block in patients that present to the emergency department with hip fractures.
Detailed description
Hip fractures often present to the emergency department and elderly, already fragile, patients are overrepresented. The pain associated with a hip fracture can be severe and have deleterious effects on the patient. Many studies, and a Cochrane review, have shown that a peripheral nerve block provides good pain relief and has many benefits compared to traditional pain relief, such as intravenous morphine. There is less consensus regarding which kind of nerve block, and which technique, is best to use. Many studies compared different kinds of nerve blocks to traditional methods, or more recently compared different kinds of ultrasound-guided techniques to each other. This study proposes to compare the widely used technique of a blind fascia iliaca compartment block (FICB) to an ultrasound-guided femoral nerve block (FNB) that is currently being rolled out locally as an alternative. During the implementation period of this new clinical routine, it will be possible to compare the efficacy of FICB and FNB in reducing participant-reported pain.
Interventions
PROCEDUREFascia Iliaca Compartment Block
Blind technique.
PROCEDUREFemoral Nerve Block
Ultrasound guided.
DRUGRopivacaine
Ropivacaine dosed according to local guidelines.
Sponsors
University Hospital, Linkoeping
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult emergency department patient over 18 years of age with a radiologically verified fracture classified as hip fracture that are eligible for a peripheral nerve block according to local guidelines
Exclusion criteria
* Multi-system trauma * Isolated pelvic or diaphyseal femur fracture * Patients unable to communicate regardless of reason * Patients with contraindications to receiving a peripheral nerve block with an amide local anaesthetic according to local guidelines
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mean Change from Baseline in Pain Scores on the Numeric Rating Scale (0 to 10, where 10 is Maximum Pain) at 30 minutes after Administration of Block, at Rest and During Active Hip Flexion | Measured 30 minutes after administered nerve block. | Change in reported pain score should be at least one whole unit on the numeric rating scale. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Ratio of Failed Blocks | Through study completion, an average of 1 year | Defined by a failure to reduce reported pain 30 minutes after administered block by at least one whole unit on the numeric rating scale |
| Rate of Complications | Through study completion, an average of 1 year | Comparing the rate of any reported complication between cohorts |
Countries
Sweden
Contacts
Primary ContactDaniel Leckström, MBBS
Backup ContactSofia Freland, PhD, MD
Outcome results
None listed