Pain management after fracture around the hip. Pericapsular block, Morphine
Conditions
Interventions
The first group after randomization
We will perform the Pericapsular nerve block (PENG) in older adults who visit the emergency department with hip fracture and has a moderate to severe pain.
One physician who has experience in PENG blo
Pericapsular nerve block,Intravenous morphine
Sponsors
Navamindradhiraj University Research Fund
Eligibility
Sex/Gender
All
Age
65 Years to 99 Years
Inclusion criteria
Inclusion criteria: 1.Patients aged 65 years and older who come to the emergency room with muscle and hip pain, and the doctor diagnosed a hip fracture within 7 days during 1 Sep. 2023 - 30 Aug. 2025 (2) The patient rated the pain as moderate to severe, that is, the level of pain greater than or equal to 5 to 10 on the verbal numerical rating scale (VNRS).
Exclusion criteria
Exclusion criteria: 1. The patient does not consent to receive PENG block anesthesia or intravenous morphine (lack of Informed consent to participate in this study). 2. The patient has unstable vital signs (hemodynamic instability), systolic blood pressure lower than 90 mmHg, heart rate less than 50 beats per minute and respiratory rate less than 10 breaths per minute. 3. Patients have conditions or other co-morbidities that have serious causes and require immediate intervention, as follows: acute myocardial infarction (STEMI), ischemic or sudden ischemic stroke or aortic dissection. 4. Patients with injuries to more than 2 systems. 5. Patients who have an underlying disease which is muscle weakness. 6.Patients with chronic pain such as pain from cancer 7. Patients who need emergency surgery (immediate surgical intervention) 8. Patients who are unable to assess pain as follows: depression (altered mental status), communication problems (communication barrier), impaired memory. 9. Severe dementia based on 6-item cognitive screening score greater than 12 10. Patients with a history of allergy to anesthetics or drugs in the morphine group (bupivacaine or morphine allergy). 11. Patients taking group drugs anti-coagulant 48 hours before coming to the hospital or have an INR value > 1.5 12. A patient with a skin infection around the broken hip joint. 13. Patients with a history of using opioid analgesics within 4 hours, including tramadol, fentanyl, morphine, codeine, pethidine, methadone, or unknown drugs. 14. Patients with a history of drug abuse within 1 month before coming to the hospital 15.Patients weighing less than 40 kg or more than 100 kg
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| To compare the effectiveness in reducing pain after applying PENG. block and after receiving intravenous morphine in the 30 minutes 30 minutes verbal numeric rating scale | — |
Secondary
| Measure | Time frame |
|---|---|
| Pain score at 0, 15, 30, 45, 60, 75, 90, 105, 120 minutes 0-120 minutes Verbal numeric rating scale,adverse events 0-120 minutes SERDA score,Rate of rescues therapy 30 minutes Use of fentanyl | — |
Countries
Thailand
Contacts
Public Contactjiraporn srion
Vajira Hospital, Navamindradhiraj University
Outcome results
None listed