Peripheral nerve blocks for hip fractures

Abstract

This review focuses on the use of peripheral nerves blocks as preoperative analgesia, as postoperative analgesia or as a supplement to general anaesthesia for hip fracture surgery. We undertook the update to look for new studies and to update the methods to reflect Cochrane standards.

Femoral nerve blocks versus standard pain control for hip fractures: a retrospective comparative analysis

“…Although these differences were not statistically significant, the trend toward shorter hospitalization suggests a potential benefit of femoral nerve blocks in expediting recovery and discharge. This finding is consistent with previous studies demonstrating the effectiveness of femoral nerve blocks in reducing hospital length of stay [ 20 , 21 ]. Several factors could contribute to the extended hospital stays for patients without femoral nerve blocks.…”

Femoral nerve blocks versus standard pain control for hip fractures: a retrospective comparative analysis

“…Although these differences were not statistically significant, the trend toward shorter hospitalization suggests a potential benefit of femoral nerve blocks in expediting recovery and discharge. This finding is consistent with previous studies demonstrating the effectiveness of femoral nerve blocks in reducing hospital length of stay [ 20 , 21 ]. Several factors could contribute to the extended hospital stays for patients without femoral nerve blocks.…”

Femoral nerve blocks for the treatment of acute pre‐hospital pain: A systematic review with meta‐analysis

“…Peripheral nerve blocks such as FNB may reduce the need for other types of analgesia later in the clinical course as reported by Büttner and co‐workers 4 . Peripheral nerve blocks have also been shown to reduce the risk of pneumonia after hip fracture and to facilitate early mobilization after hip surgery 23 …”

Advantages of the standardized use of preoperative fascia iliaca block versus conventional analgesia in older adults with fragility hip fracture: A retrospective cohort study at two hospitals in Colombia

“… 15 , 17 However, a Cochrane systematic review on the use of peripheral nerve blocks in hip fractures found no difference in the risk of delirium in seven of the 31 included trials (RR 0.69, 95% CI 0.38 to 1.27 I2 = 48%; very low quality of evidence) but there was a difference in complications such as pneumonia (RR 0.41, 95% CI 0.19 to 0.89; I2 = 3%; number needed to treat for additional beneficial outcome 7, CI 95% 5 to 72; moderate quality of evidence). 18 This demonstrates the wide spectrum of findings that exist about this topic and its complexity.…”

Femoral nerve blocks versus standard pain control for hip fractures: a retrospective comparative analysis

“…Although these differences were not statistically significant, the trend toward shorter hospitalization suggests a potential benefit of femoral nerve blocks in expediting recovery and discharge. This finding is consistent with previous studies demonstrating the effectiveness of femoral nerve blocks in reducing hospital length of stay [ 20 , 21 ]. Several factors could contribute to the extended hospital stays for patients without femoral nerve blocks.…”

Femoral nerve blocks for the treatment of acute pre‐hospital pain: A systematic review with meta‐analysis

“…Peripheral nerve blocks such as FNB may reduce the need for other types of analgesia later in the clinical course as reported by Büttner and co‐workers 4 . Peripheral nerve blocks have also been shown to reduce the risk of pneumonia after hip fracture and to facilitate early mobilization after hip surgery 23 …”

Advantages of the standardized use of preoperative fascia iliaca block versus conventional analgesia in older adults with fragility hip fracture: A retrospective cohort study at two hospitals in Colombia

“… 15 , 17 However, a Cochrane systematic review on the use of peripheral nerve blocks in hip fractures found no difference in the risk of delirium in seven of the 31 included trials (RR 0.69, 95% CI 0.38 to 1.27 I2 = 48%; very low quality of evidence) but there was a difference in complications such as pneumonia (RR 0.41, 95% CI 0.19 to 0.89; I2 = 3%; number needed to treat for additional beneficial outcome 7, CI 95% 5 to 72; moderate quality of evidence). 18 This demonstrates the wide spectrum of findings that exist about this topic and its complexity.…”

Femoral nerve blocks versus standard pain control for hip fractures: a retrospective comparative analysis

“…Although these differences were not statistically significant, the trend toward shorter hospitalization suggests a potential benefit of femoral nerve blocks in expediting recovery and discharge. This finding is consistent with previous studies demonstrating the effectiveness of femoral nerve blocks in reducing hospital length of stay [ 20 , 21 ]. Several factors could contribute to the extended hospital stays for patients without femoral nerve blocks.…”

Femoral nerve blocks for the treatment of acute pre‐hospital pain: A systematic review with meta‐analysis

“…Peripheral nerve blocks such as FNB may reduce the need for other types of analgesia later in the clinical course as reported by Büttner and co‐workers 4 . Peripheral nerve blocks have also been shown to reduce the risk of pneumonia after hip fracture and to facilitate early mobilization after hip surgery 23 …”

Advantages of the standardized use of preoperative fascia iliaca block versus conventional analgesia in older adults with fragility hip fracture: A retrospective cohort study at two hospitals in Colombia

“… 15 , 17 However, a Cochrane systematic review on the use of peripheral nerve blocks in hip fractures found no difference in the risk of delirium in seven of the 31 included trials (RR 0.69, 95% CI 0.38 to 1.27 I2 = 48%; very low quality of evidence) but there was a difference in complications such as pneumonia (RR 0.41, 95% CI 0.19 to 0.89; I2 = 3%; number needed to treat for additional beneficial outcome 7, CI 95% 5 to 72; moderate quality of evidence). 18 This demonstrates the wide spectrum of findings that exist about this topic and its complexity.…”