Pre-operative pain management with nerve block in patients with hip fractures: a randomized, controlled trial

Abstract

Introduction: Pain management in patients with hip fractures is a major challenge for emergency care. The objective of this study was to evaluate whether the supplementation of pre-operative analgesia with low-dose fascia iliaca compartment block (FICB) compared with placebo would improve pain relief in patients with hip fractures.

Methods: A double-blind, randomized, controlled trial was conducted on 127 patients. At hospital admission, a low-dose FICB was administered to patients with hip fractures as a supplement to regular pre-operative analgesia. Patients with and without cognitive impairment were included. The instruments used were a visual analogue scale (VAS), a numerical rating scale and a tool for behavior related pain assessment. The primary endpoint was the change in reported pain on movement from hospital admission to two hours after FICB.

Results: The intervention group showed improved pain management by mean VAS score for pain on movement compared with the control group (p = 0.002).

Conclusions: Our results support the use of low-dose FICB as a pain-relieving adjuvant to other analgesics when administered to patients with a hip fracture.

Keywords: Analgesia; Fascia iliaca compartment block; Hip fractures; Nerve block; Pain; Pain management.