Evaluation of the Effect of Perioperative Continuous Lumbar Plexus Block Upon the Incidence of Ischemic Cardiovascular Events in Elderly Patients With Hip Fracture.
Overview
- Phase
- Phase 4
- Intervention
- Intravenous patient-controlled analgesia
- Conditions
- Hip Fractures
- Sponsor
- Pontificia Universidad Catolica de Chile
- Enrollment
- 31
- Locations
- 2
- Primary Endpoint
- evaluate the efficacy of perioperative continuous lumbar plexus block in reducing the risk of cardiac ischemic events of elderly patients undergoing surgery for hip fractures, expressed as a reduction of ischemic events per subject.
- Status
- Completed
- Last Updated
- 12 years ago
Overview
Brief Summary
The purpose of this study is evaluate the efficacy of perioperative continuous lumbar plexus block in reducing the risk of cardiac ischemic events of elderly patients undergoing surgery for hip fractures, expressed as a reduction of ischemic events per subject.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Patients with hip fracture within 48 hours of evolution
- •Known coronary artery disease:
- •Previous myocardial infarction Chronic stable angina Atypical angina with positive exercise test for coronary flow failure. Evidence of coronary artery disease with ultrasound, scintigraphic or angiographic compatible
- •Patients with at least two of the risk factors for coronary heart disease as defined by Wallace (1998)
Exclusion Criteria
- •Patients receiving orthopedic treatment.
- •Patients with coagulopathy, clinic or laboratory.
- •Patients with sepsis or infection of the catheter insertion site of lumbar plexus.
- •Patients with neurological diseases evolving.
- •Patients disoriented, or dementia.
- •CKD stage IV National Kidney Foundation (2)
- •Glomerular filtration rate between 15 and 29 mL/min/1, 73 m2
- •Patients unable to use the Numeric Rating Scale (NRS) to assess pain.
- •Patients with non-sinus rhythm or conduction abnormalities (right bundle branch block or left, atrioventricular block) in the admission ECG
- •Patients with pacemaker.
Arms & Interventions
Intravenous patient-controlled analgesia
Intravenous morphine solution 0.2 mg / ml in PCA mode without basal infusion, 1mg bolus demand and lockout of 8 minutes.
Intervention: Intravenous patient-controlled analgesia
Continuous lumbar plexus (LP) block analgesia
Continuous lumbar plexus (LP) block analgesia. Continuous infusion of a solution of 0.1% bupivacaine in PCA mode, programmed at 8 ml / h. Rescue bolus 5 ml and 30 minutes lockout
Intervention: Continuous lumbar plexus (LP) block analgesia
Outcomes
Primary Outcomes
evaluate the efficacy of perioperative continuous lumbar plexus block in reducing the risk of cardiac ischemic events of elderly patients undergoing surgery for hip fractures, expressed as a reduction of ischemic events per subject.
Time Frame: 3 days
Secondary Outcomes
- Perioperative Pain Intensity, measured in numerical rating scale (NRS).(3 days)
- Death at 30, 90 and 360 days after surgery(1 year)
- Major cardiovascular events (myocardial infarction, acute pulmonary edema, arrhythmias).(3 days)
- hospital death(3 days)
- Evaluate Adverse events (hypotension, respiratory depression, systemic toxicity, etc..)(3 days)