Femoral Nerve Block, Hip Fracture Surgeries, Iliopsoas Nerve Block
Conditions
Brief summary
This study aims to compare iliopsoas nerve Block (IPB) to femoral nerve block (FNB) regarding pain control, patient satisfaction, and early ambulation in patients undergoing hip fracture surgeries
Detailed description
Hip fractures are among the most frequent fractures seen in the emergency department and orthopedic trauma teams. The terms hip fracture and neck of femur fracture are used synonymously. Both terms describe a proximal femur fracture between the femoral head and 5 cm distal to the lesser trochanter. Iliopsoas nerve Block (IPB) is a promising motor-sparing analgesic technique that selectively targets the sensory branches of the hip joint originating from the femoral nerve and accessory obturator nerve, sparing the motor supply of quadriceps muscles. A femoral nerve block (FNB) is a simple nerve block that can be performed easily without or under ultrasound guidance. Under ultrasound guidance, the femoral artery and femoral nerve were identified clearly, and a needle was inserted using an in-plane approach from the lateral to the medial direction. Once the needle tip's position was confirmed, 10 ml of 0.5% bupivacaine was injected adjacent to the femoral nerve.
Interventions
Patients will receive an Iliopsoas nerve block using 10 ml of bupivacaine 0.5%.
DRUGFemoral nerve block
Patients will receive femoral nerve block using 10 ml of bupivacaine 0.5%.
Sponsors
Ain Shams University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Age from 18 to 65 years. * Both sexes. * American Society of Anesthesiologists (ASA) physical status I and II. * Patients who are scheduled for elective surgical correction of hip fracture either through open fracture internal fixation (ORIF), partial hip arthroplasty or total hip arthroplasty.
Exclusion criteria
* Refusal to participate. * Coagulopathy. * Patients with a history of drug allergies to study drugs. * Inability to cooperate.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Degree of pain | 24 hours postoperatively | Each patient will be instructed about postoperative pain assessment with the numeric rating scale (NRS) score. NRS (0 represents no pain while 10 represents the worst pain imaginable). NRS will be assessed upon arrival at the post-anesthesia care unit (PACU) and at 2, 4, 6,12, 24 post-surgery. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total opioids consumption | 24 hours postoperatively | Intravenous pethidine (25mg) will be given to be repeated after 15 min if no response up to a maximum dose of 50 mg In case of moderate to sever pain. |
| Assessment of quadriceps strength | 24 hours postoperatively | The quadriceps strength will be assessed using the manual muscle testing (MMT) grade (0-5; 0: no muscle contraction, 1: muscle contraction present but unable move joint, 2: able to move joint but not resist gravity, 3: able to resist gravity but not bear substantial resistance, 4: able to resist some level of substantial resistance, 5: able to resist full resistance). |
| Time of ambulation | 24 hours postoperatively | Time of ambulation will be recorded from the end of surgery till walking or moving from place to place |
| Patients' satisfaction | 24 hours postoperatively | Degree of patient satisfaction will be assessed on a 5-point Likert scale patient satisfaction (1, extremely dissatisfied; 2, unsatisfied; 3, neutral; 4, satisfied; 5, extremely satisfied) |
| Incidence of complications | 24 hours postoperatively | Any complication will be recorded. |
Countries
Egypt
Contacts
Primary ContactHazem K Saeed, Master
Outcome results
None listed