Abstract
Background
The local anesthetic dosages used in the current literature in regional applications
of local anesthetics are frequently high for surgical purposes, and there are no sufficient
dosage studies for emergency department (ED) management.
Objectives
The aim of this study was to determine the success of lower local anesthetic dosages
capable of reducing costs and excessive exposure to drugs in pain control in patients
with femoral neck fractures (FNFs) in the ED.
Methods
Patients ≥65 years of age with FNFs and reporting Wong-Baker Pain Rating Scales scores
≥8 were included in this prospective, interventional study. Patients underwent ultrasound-guided
regional femoral block with 5 mL 2% prilocaine. Pain scores before the procedure and
at 30 min and 2 h postprocedure were compared with the Friedman test and Wilcoxon
test with Bonferroni correction.
Results
Forty patients, 20 with intracapsular and 20 with extracapsular FNFs, were enrolled.
The initial pain scores of patients with both intra- and extracapsular fractures were
8 (range 8–10). A statistically significant 50% decrease in pain scores was observed
in both groups 30 min after the regional block procedure (p < 0.001). A statistically significant 75% decrease in pain scores was observed in
both groups 2 h after the regional block procedure (p < 0.001). No statistically significant difference was determined in the change in
30-min and 2-h pain scores between the groups.
Conclusions
The administration of 5 mL 2% prilocaine for pain control in FNFs in elderly patients
in the ED can reduce systemic analgesic requirements by establishing effective analgesia
in both intracapsular and extracapsular fractures.
Keywords
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Article info
Publication history
Published online: February 16, 2020
Accepted:
December 25,
2019
Received in revised form:
December 25,
2019
Received:
October 12,
2019
Footnotes
Reprints are not available from the authors.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
