Hip Fracture, Lumbar Erector Spinae Plane Block, Multimodal Analgesia, Pain Management, Peripheral Nerve Block, Suprainguinal Fasia Iliaca Block
Conditions
Keywords
Hip fracture, pain management, multimodal analgesia, suprainguinal fasia iliaca block, lumbar erector spinae plane block
Brief summary
The aim of our study was to evaluate the efficacy and patient satisfaction level of SI-FIB and lumbar ESPB for positioning and postoperative analgesia during spinal anesthesia in patients undergoing hip fracture surgery.
Detailed description
Hip fractures, which are one of the leading causes of mortality and morbidity with increasing age, are common and usually require surgery and cause severe pain in the perioperative period, which may result in delirium, sleep disturbances and chronic pain. This pain can be managed using neuraxial and regional techniques, as well as pharmacologic agents such as nonsteroidal analgesics, opioids and gabapentinoids, and interventions such as periarticular injections and peripheral nerve blocks. Supra-inguinal fascia iliaca block (SI-FIB) is a technique that blocks all components of the lumbar plexus, including the femoral nerve, latero-femoral nerve and obturator nerve. It is thought to function in a similar way to the anterior lumbar plexus block. Studies have successfully demonstrated the effectiveness of SIFIB in reducing postoperative pain after hip surgery. The lumbar erector spina plan block (ESPB) has been described for use in hip and femur surgery and radiologic evaluation and clinical results have shown that it provides similar analgesia to the lumbar plexus block at high volumes. It is accepted that multimodal analgesia is the best option for pain control and peripheral nerve blocks are effectively applied for this purpose. In this way, opioid use and related side effects such as nausea, vomiting, pruritus and sedation are reduced, and early mobilization, reduced hospital stay and prevention of postoperative complications are also contributed.
Interventions
None listed
Sponsors
Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 18 years of age or older * American Society of Anesthesiologists (ASA) I-III risk class, * Patients and/or guardians informed and given informed consent regarding the study
Exclusion criteria
* Central-autonomic nervous system or neuropsychiatric disorders, * Opioid use, * Contraindications for the planned block, * Known allergies to the medications to be administered, * Patients who refuse to participate in the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Assessment of pain during spinal anesthesia position | The NRS score will be recorded before the block. The NRS score will be recorded 20 minutes after the block is administered. The NRS score will be recorded when the patient is placed in a sitting position for spinal anesthesia. | The primary objective of our study is to compare the effectiveness of SI-FIB and lumbar ESPB in patients undergoing hip fracture surgery by evaluating NRS scores during positioning for spinal anesthesia. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative Pain Intensity at Rest and During Activity | 0, 2, 6, 12, and 24 hours postoperatively | Postoperative pain intensity at rest and during activity will be assessed using the Numeric Rating Scale. The Numeric Rating Scale ranges from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain. Higher scores indicate worse pain. Unit of Measure: Numeric Rating Scale score |
| Additional Analgesic Consumption | From the end of surgery to 24 hours postoperatively | Additional analgesic consumption will be recorded as the total amount of analgesic administered postoperatively. |
| Patient Satisfaction With Postoperative Analgesia | 24 hours postoperatively | Postoperative quality of recovery will be assessed using the 15-item Quality of Recovery questionnaire (QoR-15). The total score ranges from 0 to 150, with higher scores indicating better postoperative recovery. |
Countries
Turkey (Türkiye)
Outcome results
None listed