Abstract
Background
Hip fracture (HFx) is a painful injury that is commonly seen in the emergency department
(ED). Patients who experience pain from HFx are often treated with intravenous opiates,
which may cause deleterious side effects, particularly in elderly patients. An alternative
to systemic opioid analgesia involves peripheral nerve blockade. This approach may
be ideally suited for the ED environment, where one injection could control pain for
many hours.
Objectives
We hypothesized that an ultrasound-guided fascia iliaca compartment block (UFIB) would
provide analgesia for patients presenting to the ED with pain from HFx and that this
procedure could be performed safely by emergency physicians (EP) after a brief training.
Methods
In this prospective, observational, feasibility study, a convenience sample of 20
cognitively intact patients with isolated HFx had a UFIB performed. Numerical pain
scores, vital signs, and side effects were recorded before and after administration
of the UFIB at pre-determined time points for 8 h.
Results
All patients reported decreased pain after the nerve block, with a 76% reduction in
mean pain score at 120 min. There were no procedural complications.
Conclusion
In this small group of ED patients, UFIB provided excellent analgesia without complications
and may be a useful adjunct to systemic pain control for HFx.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Emergency MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
Department of Health and Human Services, the Centers for Disease Control. National Hospital Discharge Survey (NHDS), National Center for Health Statistics, 2004. Available at: http://www.cdc.gov.
- The effect of emergency department crowding on the management of pain in older adults with hip fracture.J Am Geriatr Soc. 2006; 54: 270-275
- Ultrasonographic guidance reduces the amount of local anesthetic for 3-in-1 blocks.Reg Anesth Pain Med. 1998; 23: 584-588
- Effects of ultrasound guidance on the minimum effective anaesthetic volume required to block the femoral nerve.Br J Anaesth. 2007; 98: 823-827
- Ultrasonographic guidance improves sensory block and onset time of three-in-one blocks.Anesth Analg. 1997; 85: 854-857
- Use of ultrasound to facilitate accurate femoral nerve block in the emergency department.Emerg Med Australas. 2009; 21: 124-130
- Fascia iliaca compartment blockade for acute pain control in hip fracture patients: a randomized, placebo-controlled trial.Anesthesiology. 2007; 106: 773-778
- Single fascia iliaca compartment block for post-hip fracture pain relief.J Emerg Med. 2007; 32: 257-262
- A randomized controlled trial comparing a fascia iliaca compartment nerve block to a traditional systemic analgesic for femur fractures in a pediatric emergency department.Ann Emerg Med. 2007; 50: 162-171
- Comparison of the fascia iliaca compartment block with the 3-in-1 block in children.Anesth Analg. 1989; 69: 705-713
- Ultrasound guided fascia iliaca block: a comparison with the loss of resistance technique.Reg Anesth Pain Med. 2008; 33: 526-531
Article info
Publication history
Published online: April 11, 2012
Accepted:
January 22,
2012
Received in revised form:
August 30,
2011
Received:
June 28,
2011
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
