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. 2015:2015:316817.
doi: 10.1155/2015/316817. Epub 2015 Nov 16.

Local Anaesthetic Infiltration and Indwelling Postoperative Wound Catheters for Patients with Hip Fracture Reduce Death Rates and Length of Stay

William D Harrison  1 , Deborah Lees  1 , Jamie A'Court  1 , Thomas Ankers  1 , Ian Harper  1 , Dominic Inman  1 , Mike R Reed  1
Affiliations

Local Anaesthetic Infiltration and Indwelling Postoperative Wound Catheters for Patients with Hip Fracture Reduce Death Rates and Length of Stay

William D Harrison et al. Surg Res Pract. 2015.

Abstract

Background. An analgesic enhanced recovery (ER) protocol for patients with a hip fracture was introduced. It was hypothesised that the ER would reduce pain, length of stay and improve clinical outcomes. The protocol used intraoperative infiltration of levobupivacaine followed by ongoing wound infusions. Methods. Consecutive patients admitted to two hospitals were eligible for the ER protocol. Numerical Reporting Scale pain scores (0-10) were recorded alongside opiate requirements. 434 patients in the ER group (316 full ER, 90 partial ER, and 28 no ER) were compared to a control group (CG) of 100 consecutive patients managed with traditional opiate analgesia. Results. Mean opiate requirement was 49.2 mg (CG) versus 32.5 mg (ER). Pain scores were significantly reduced in the full ER group, p < 0.0001. Direct discharge home and mean acute inpatient stay were significantly reduced (p = 0.0031 and p < 0.0001, resp.). 30-day mortality was 15% (CG) versus 5.5% (ER), p = 0.0024. Conclusions. This analgesic ER protocol for patients with a hip fracture was safe and effective and was associated with reduced inpatient stay and mortality.

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Figures

Figure 1
Figure 1
Numerical Reporting Scale (NRS) pain scores for the control group and the enhanced recovery subgroups.
See this image and copyright information in PMC

References

    1. Dillon J. P., Brennan L., Mitchell D. Local infiltration analgesia in hip and knee arthroplasty: an emerging technique. Acta Orthopaedica Belgica. 2012;78(2):158–163. - PubMed
    1. Kerr D. R., Kohan L. Local infiltration analgesia: a technique for the control of acute postoperative pain following knee and hip surgery—a case study of 325 patients. Acta Orthopaedica. 2008;79(2):174–183. doi: 10.1080/17453670710014950. - DOI - PubMed
    1. Malviya A., Martin K., Harper I., et al. Enhanced recovery program for hip and knee replacement reduces death rate. Acta Orthopaedica. 2011;82(5):577–581. doi: 10.3109/17453674.2011.618911. - DOI - PMC - PubMed
    1. National Clinical Guideline Centre. The Management of Hip Fracture in Adults. London, UK: Royal College of Physicians; 2011. (NICE Clinical Guidelines no. 124).
    1. Kehlet H., Andersen L. Ø. Local infiltration analgesia in joint replacement: the evidence and recommendations for clinical practice. Acta Anaesthesiologica Scandinavica. 2011;55(7):778–784. doi: 10.1111/j.1399-6576.2011.02429.x. - DOI - PubMed

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