Femoral nerve block versus intravenous fentanyl in adult patients with hip fractures – a systematic review

Hartmann, Flávia Vieira Guimarães; Novaes, María Rita Carvalho Garbi; Carvalho, Marta Rodrigues de

doi:10.1016/j.bjane.2015.08.017

Cited by 14 publications

(10 citation statements)

References 19 publications

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“… 8 Regional anesthesia of the femoral nerve represents a proven therapy for pain control in patients with hip fractures. 4 , 5 , 7 , 9 US-guided femoral nerve blocks provide similarly demonstrated effective pain control for patients with hip fractures, and in some select surgical procedures. 6 …”

Section: Discussionmentioning

confidence: 97%

Ultrasound-Guided Femoral Nerve Block to Facilitate the Closed Reduction of a Dislocated Hip Prosthesis

Carlin

Stankard

Voroba

et al. 2017

CPC-EM

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Prosthetic hip dislocation is a common but unfortunate complication in patients who have undergone total hip arthroplasty. Successful closed reduction in the emergency department leads to a reduced length of stay and rate of hospitalization.1,2 The use of regional anesthesia by femoral nerve block represents a novel approach for controlling pain in patients with hip pathologies.3 Ultrasound-guided approaches have been used with great success for controlling pain in patients with hip fractures.4,5 Here we report the case of a 90-year-old male who presented with a dislocated hip prosthesis, which was subsequently corrected with closed reduction following delivery of regional anesthesia to the femoral nerve under ultrasound guidance. To our knowledge, this represents the first reported use of an ultrasound-guided femoral nerve block to facilitate closed reduction of a dislocated prosthetic hip, and highlights a novel approach that avoids the use of procedural sedation in an elderly patient.

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Section: Discussionmentioning

confidence: 97%

Ultrasound-Guided Femoral Nerve Block to Facilitate the Closed Reduction of a Dislocated Hip Prosthesis

Carlin

Stankard

Voroba

et al. 2017

CPC-EM

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“…Regional anesthesia technique has several physiological advantages such as optimal pain relief, attenuation of proinflammatory and endocrine stress response, improved tissue and coronary perfusion, less inhibition of diaphragm activity 22 . This technique looks like superior than general anesthesia in early postoperative time 23,24 . However long-term effects of regional anesthesia are still investigating 25 .…”

Section: Discussionmentioning

confidence: 97%

Erişkin hastalarda genel ve rejyonel anestezinin kemik belirteçleri ve kırık iyileşmesi üzerine uzun dönem etkileri

Biricik¹,

Karacaer²,

Güleç³

et al. 2019

Cukurova Medical Journal

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Bone metabolism can be monitored quantitatively by measuring bone turnover markers in serum and/or urine. We aimed to investigate long-term effect of the type of the anesthesia on bone turnover markers and fracture healing. Materials and Methods: Thirty patients with American Society of Anesthesiologist physical status I-II whom were aged 40-70 years, scheduled for hip fracture were recruited. Patients were divided into the two groups as general anesthesia and regional anesthesia. Only morphine and tramadol were used for postoperative analgesia till the 12 th weeks. Serum bone-specific alkaline phosphatase, osteocalcine, β-C terminal telopeptide and urine β-C terminal telopeptide levels were measured at preoperative, 4 th week and 12 th week of fracture. Results: A total of 25 patients were eligible for the study. There were no statistically significant between groups for values of bone turnover markers at the time point of preoperative, 4 th and 12 th weeks. With using linear regression analysis, serum β-CTX levels at 12 th week can be predict by 4 th weeks β-CTX levels (R2: 0.944) and urine β-CTX levels at 12 th week can be predict by first week level. Conclusions: This pilot study showed that both general and regional anesthesia has similar effect on bone turnover markers and fracture healing. Amaç: Kemik metabolizması serum ve/veya idrarda kemik belirteçlerinin ölçülmesi ile kanditatif olarak izlenebilmektedir. Anestezi tipinin kemik belirteçleri ve kırık iyileşmesi üzerine uzun dönem etkilerini araştırmayı amaçladık. Gereç ve Yöntem: Amerikan Anestezi Cemiyeti klinik durum klasifikasyonu I-II olan 40-70 yaş arası kalça fraktürü nedeniyle opere olacak 30 hasta çalışmaya dahil edildi. Hastalar genel ve rejyonel anestezi olarak iki gruba ayrıldı. Postoperatif analjezi için 12 th haftaya kadar sadece tramadol kullanıldı. Serum kemik spesifik alkalen fosfataz, osteokalsin, β-C terminal telopeptide ve idrar β-C terminal telopeptide düzeyleri postoperatif 4 th ve 12 th haftalarda ölçüldü. Bulgular: Toplam 25 hasta çalışmaya uygun bulundu. Postoperatif 4 th ve 12 th haftalardaki kemik belirteçleri açısından gruplar arasında istatistiksel olarak anlamlı fark bulunamadı. Lineer regresyon analizi uygulandığında 4 th haftadaki β-CTX düzeyi ile 12 th haftadaki serum β-CTX seviyelerinin (R2: 0.944) ve ilk haftadaki idrar β-CTX düzeyleri ile 12 th haftadaki idrar β-CTX seviyelerinin tahmin edilebileceği tespit edildi. Sonuç: Bu pilot çalışma genel ve rejyonel anestezinin kemik belirteçleri ve kırık iyileşmesi üzerine benzer etkisi olduğunu göstermiştir.

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“…Nye ZB et al found that continuous posterior lumbar plexus block is a suitable method even for ambulatory hip arthroscopy. ( 45 , 46 ) Sciatic nerve block provides postoperative analgesia for knee surgery, below knee surgery and ankle surgery. Single shot sciatic nerve block with posterior approach (Labat) provides effective postoperative analgesia in majority of the patients for up to 18 hours when combined with spinal anesthesia intraoperatively.…”

Section: Peripheral Nerve Blocksmentioning

confidence: 99%

Regional Analgesia Modalities in Abdominal and Lower Limb Surgery - Comparison of Efficacy

Peršec

Šerić

2019

ACC

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SUMMARYA significant component of all surgical procedures and postoperative treatment is pain management.Due to the physiological and psychological advantages of pain relief, it is one of the foremost indicators of quality of care. Today, there are various modalities of pain reduction, aimed to reduce patient discomfort andminimize side effects, which can be divided by therapeutic agents used (opioid or non-opioid), route of administration (intravenous, regional, oral, etc.) and modality (controlled by patients or “as needed”). Although opioids have proven to be very effective pain relief agents and are commonly used in postoperative analgesia, concerns about their side effects have spurred the development of modified, multimodal treatments that seek to minimize opioid use and associated drawbacks. Enhanced recovery protocols that emphasize sparing administration of opioids are growing in importance, andresulting in reduced length of hospital stay after abdominal and lower limb surgery. To further improve such protocols and optimize postoperative care for individual patient needs, it is imperative to fully assess the efficacy of available drugs and analgesia modalities.

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Femoral nerve block versus intravenous fentanyl in adult patients with hip fractures – a systematic review

Abstract: The use of femoral nerve block can reduce the level of pain and the need for additional analgesia. There are less adverse systemic events associated with this and the procedure itself does not offer greater risks. More studies are required for further conclusions.

Cited by 14 publications

References 19 publications

Ultrasound-Guided Femoral Nerve Block to Facilitate the Closed Reduction of a Dislocated Hip Prosthesis

Ultrasound-Guided Femoral Nerve Block to Facilitate the Closed Reduction of a Dislocated Hip Prosthesis

Erişkin hastalarda genel ve rejyonel anestezinin kemik belirteçleri ve kırık iyileşmesi üzerine uzun dönem etkileri

Regional Analgesia Modalities in Abdominal and Lower Limb Surgery - Comparison of Efficacy

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