Combined Plexus Block for Hip Fracture Surgery.

Completed

• Conditions: Hip Fractures
• Interventions: Other: no intervention

• Registration Number: NCT03356704
• Lead Sponsor: University Hospital, Montpellier

Brief Summary

Hip fracture surgery requires high risk anesthetic procedure for elderly patients (1). General anesthesia, continuous spinal anesthesia and peripheral nerve blocks are three anesthetic techniques possible. Continuous spinal anesthesia has proven its efficacity to provide an intraoperative haemodynamic stability wich guarantees good patients outcomes (2), in comparison with general anesthesia but there is poor evidence in the literature concerning the use of peripheral nerve blocks.

The primary objective of this study was to compare intraoperative haemodynamic stability provides by peripheral nerve block versus general anesthesia and continuous spinal anesthesia.

Secondary outcomes included : use of vasoactive drugs, opioids consumption, lengh of stay and inhospital mortality.

Detailed Description

After receiving the ethic approval from the "CERAR", the investigators retrospectively identified all patients who underwent hip fracture surgery from January 1 2015, to December 31, 2016 in the CHU of Montpellier. The exclusion criteria were: multiple trauma victims, two hip fractures in the same patient and single shot spinal anesthesia. In our institution the investigators used to perform three types of anesthesia: general anesthesia (GA), continuous spinal anesthesia (CSA) and combined plexus blocks (CPB). The investigators therefore made three groups GA, CSA and CPB and used a propensity score to make these groups comparable. The matching criteria were age, arterial hypertension, ASA status, Frailty score, chronic cardiac failure and type of surgery.

Study Timeline

• Study Start: 2016-08-31
• Primary Completion: 2017-02-01
• Status Verified: 2017-10
• Study Completion: 2017-10-26
• Study First Submitted: 2017-10-26
• Study First Submitted QC: 2017-11-28
• Study First Posted: 2017-11-29
• Last Update Submitted: 2018-07-17
• Last Update Posted: 2018-07-19

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 593

Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
peripheral nerve blocks	no intervention	Patient who had surgery for femoral neck fracture from January 2014 to December 2016 and had peripheral nerve blocks
continued spinal anesthesia	no intervention	Patient who had surgery for femoral neck fracture from January 2014 to December 2016 and had continued spinal anesthesia
General anaesthesia	no intervention	Patient who had surgery for femoral neck fracture from January 2014 to December 2016 and had general anesthesia

Primary Outcome Measures

Name	Time	Method
Intraoperative hypotension	1 day	Decrease of at least 30% of mean arterial pressure

Secondary Outcome Measures

Name	Time	Method
compare the use of emergency antalgics	1 day	compare the use of emergency antalgics : opioids consumption
Inhospital mortality	1 day	Inhospital mortality
Length of stay	1 day	Length of stay
measure the total consumption of the vasopressive molecules	1 day	measure the total consumption of the vasopressive molecules (necessary when the voltage drops by more than 30% compared to the average reference voltage) : Use of vasoactive drugs