Analgesic Effect of Blind Fascia Iliaca Compartment Block Compared to an Ultrasound-guided Femoral Nerve Block in Patients With Hip Fractures
Overview
- Phase
- Not Applicable
- Intervention
- Fascia Iliaca Compartment Block
- Conditions
- Hip Fractures
- Sponsor
- University Hospital, Linkoeping
- Enrollment
- 100
- Locations
- 1
- Primary Endpoint
- 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
- Last Updated
- 3 years ago
Overview
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.
Investigators
Daniel Wilhelms
MD, Emergency Department Head of Research
University Hospital, Linkoeping
Eligibility Criteria
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
Arms & Interventions
Fascia Iliaca Compartment Block (FICB)
Participants with a radiologically verified hip fracture receiving a FICB using a blind technique guided by anatomical landmarks.
Intervention: Fascia Iliaca Compartment Block
Fascia Iliaca Compartment Block (FICB)
Participants with a radiologically verified hip fracture receiving a FICB using a blind technique guided by anatomical landmarks.
Intervention: Ropivacaine
Femoral Nerve Block (FNB)
Participants with a radiologically verified hip fracture receiving a FNB using ultrasound guidance for direct nerve visualisation.
Intervention: Femoral Nerve Block
Femoral Nerve Block (FNB)
Participants with a radiologically verified hip fracture receiving a FNB using ultrasound guidance for direct nerve visualisation.
Intervention: Ropivacaine
Outcomes
Primary Outcomes
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
Time Frame: 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 Outcomes
- Rate of Complications(Through study completion, an average of 1 year)
- Ratio of Failed Blocks(Through study completion, an average of 1 year)