Effect of regional nerve block for pain relief and improving prehospital general conditions of geriatric patients with hip fracture
ZHOU Yan
SHI Jing
CHONG Hao
XI Yang
WANG Geng
YANG Ming-hui
WU Xin-bao
Abstract：Objective To assess whether fascial iliac compartment block for elderly hip fracture patients in the emergency room before hospitalization can provide better pain control, superior general condition and improve quality of life during the hospitalization.Methods Patients aged 65 years or older who underwent surgery within 48 h of admission, between June 2015 and August 2016 were enrolled into this study. Patients were randomly assignedinto 2 groups: those in F group underwent ultrasound guided fascial iliac compartment block using 0.4% ropivacaine mixed with 5 mg dexamethasione 35 ml and those in C group were evaluated in the ER without nerve block. Outcomes including visual analogue scale ( VAS ), vital signs, the rescue painkillers dose, sleep quality, waiting time to surgery, delirium and thrombus incidence, block related and post-op complications were compared between groups.Results Pain level significantly decreased in F group 30 mins after block indicated by a lower VAS ( VAS, at rest 28 ± 9vs. 82 ± 11,P < 0.01; VAS in motor 55 ± 9vs. 89 ± 9,P < 0.01 ), as well as the vital signs including mean arterial pressure ( MAP, 85 ± 13vs. 89 ± 13, P< 0.01 ) and heart rate ( HR, 71 ± 14vs. 76 ± 18,P < 0.01 ). VAS in motor remained lower during the first 2 days after block in F group, but VAS at rest had no difference between groups. Meanwhile, sleep quality was impressively improved in F group during the first 2 days [ 3 ( 2 - 5 )vs. 5 ( 3 - 8 ),P < 0.01; 4 ( 3 - 8 ) vs. 6 ( 2 - 8 ),P < 0.01 ]. Besides, nausea ( 6 / 75vs. 45 / 132,P < 0.01 ), dizziness ( 4 / 75vs. 42 / 132,P < 0.01 ) and delirium incidence ( 1 / 75vs. 16 / 132, P < 0.01 ) was lower and waiting time to surgery was shortened [ 44 ( 37 - 71 ) vs. 65 ( 43 - 94 ) h,P = 0.001 ] in group F. Side effect included drowsiness, urinary retention and complications including DVT, pneumonia and decubitus had no difference between groups.Conclusions Early surgical intervention within 48 h of admission in elderly hip fracture patients with the aid of fascial iliac compartment block can provide better control of pain, superior general condition and improved quality of life during hospitalization.
Keywords：HipHip injuriesFracturesPainAnalgesiaPrognosisFascia iliac compartment block
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 180-185 )