"Analgesic Efficacy of Single-shot Versus Continuous Supra-inguinal Fascia Iliaca Compartment Block (S-FICB) using Ropivacaine for Elderly Proximal Femur Fracture patient ni the EmergencyDepartment: ARandomizedControledStudy."
Overview
- Phase
- Not Applicable
- Status
- Recruiting
- Sponsor
- AIIMSBHUBANESWAR
- Enrollment
- 54
- Locations
- 1
- Primary Endpoint
- We will evaluate the Visual Analogue Scale at rest. The baseline value (T0),30 minutes after procedure (T1),subsequently at 6 hours( T2),12 hours(T3) and 24 hours(T4) following the block.
Overview
Brief Summary
Hip and proximal femur fractures, comprising 20% of all fractures in the elderly, are rising due to the aging population.Intense pain associated with proximal femur fractures can be worsened by position changes during examination, transport, or treatment. This augmented pain response can trigger adverse cardiovascular and cerebrovascular complications.
The Fascia Iliac Block is increasingly used to reduce hip fracture pain**.** In recent years, USG -a guided supra-inguinal FICB approach has emerged as a novel method for performing FICB. It is safely performed with minimal risk as the needle trajectory does not cross major vessels, and the intended site of drug deposition is relatively superficial. The Supra inguinal approach, a recent advance over the conventional approach, ensures a more consistent spread of Local anesthetics (LA). It provides (80%) sensory blockade of the thigh than the previous method(30%).
The single-shot S-FICB provides analgesia for approximately eight hours**,** and few other studies show that its effect starts wearing off around 24 hrs. We wanted to prolong the analgesia period by inserting a catheter and providing continuous LA infusion through the elastomeric infusion system without electricity. It gives a consistent supply of drugs and does not require detachment during transportation.
Hence this study is designed to assess and compare the analgesic efficacy of USG-guided single-shot Suprainguinal Fascia Iliaca Compartment Block (S-FICB) to Continuous S-FICB using a continuous catheter and infusing through an elastomeric infusion pump in elderly patients with proximal femur fracture presenting to to the Emergency Department (ED).
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Masking
- None
Eligibility Criteria
- Ages
- 60.00 Year(s) to 90.00 Year(s) (—)
- Sex
- All
Inclusion Criteria
- •Patients of either sex aged 60 years to 90 years with (ASA) physical status I-IV presenting to ED with acute proximal femur fracture.
Exclusion Criteria
- •Exclusion criteria: 1) other organ severe trauma with unstable hemodynamics at the presentation.
- •coagulation disorder 3) Taking Analgesics for a longer duration or with opioid addiction 4) History of allergy to local anesthetics 6) Having cognitive impairment.
- •Puncture site infection 8) Abnormal neurological status of the lower limbs 9) voluntary withdrawal by patients.
Outcomes
Primary Outcomes
We will evaluate the Visual Analogue Scale at rest. The baseline value (T0),30 minutes after procedure (T1),subsequently at 6 hours( T2),12 hours(T3) and 24 hours(T4) following the block.
Time Frame: We will evaluate the Visual Analogue Scale at rest. The baseline value (T0),30 minutes after procedure (T1),subsequently at 6 hours( T2),12 hours(T3) and 24 hours(T4) following the block.
Secondary Outcomes
- MAP, HR, SPO2 at the time of evaluation of VAS(The amount of opioids as a rescue analgesia)
Investigators
Subhasree Das
Department Of Trauma and Emergency,AIIMS Bhubaneswar