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Ultrasound in Emergency Medicine| Volume 43, ISSUE 4, P692-697, October 2012

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Ultrasound-Guided Fascia Iliaca Compartment Block for Hip Fractures in the Emergency Department

      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

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      References

      1. 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.

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