Pre-operative pain management with nerve block in patients with hip fractures: a randomized, controlled trial

Wennberg, Pär; Norlin, Rolf; Herlitz, Johan; Sarenmalm, Elisabeth Kenne; Möller, Margareta

doi:10.1016/j.ijotn.2018.11.003

Cited by 18 publications

(11 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This study may have been underpowered in order adequately to address its primary aim. The main purpose of the original study was to examine pain control through FICB and sample size calculation was therefore performed using data on pain with a calculated power of 90% [27]. The present results in this paper show a 6% deterioration in SPMSQ score in the intervention group compared with a 13% deterioration in the control group.…”

Section: Discussionmentioning

confidence: 67%

“…The patients in this study were participants in a double-blind, randomised, controlled trial [27]. In brief, the purpose of this randomised, controlled trial was to evaluate preoperative pain management with FICB in patients with hip fractures.…”

Section: Methodsmentioning

confidence: 99%

“…The BRS is a three-category scale categorising pain from the patients’ behaviour. The three categories are: 1 – no pain or mild pain, 2 – moderate pain and 3 – severe pain [27].…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Fascia iliaca compartment block as a preoperative analgesic in elderly patients with hip fractures – effects on cognition

et al. 2019

Self Cite

View full text Add to dashboard Cite

Background Impaired cognition is a major risk factor for perioperative delirium. It is essential to provide good pain control in patients with hip fractures and especially important in patients with severely impaired cognitive status, as they receive less pain medication, have poorer mobility, poorer quality of life and higher mortality than patients with intact cognition. The purpose of this study was to examine the association between preoperative pain management with nerve blocks and cognitive status in patients with hip fractures during the perioperative period. Methods One hundred and twenty-seven patients with hip fractures participating in a double-blind, randomised, controlled trial were included in this study. At hospital admission, a low-dose fascia iliaca compartment block (FICB) was administered as a supplement to regular analgesia. Cognitive status was registered on arrival at hospital before FICB and on the first postoperative day using the Short Portable Mental Status Questionnaire. Results Changes in cognitive status from arrival at hospital to the first postoperative day showed a positive, albeit not significant, trend in favour of the intervention group. The results also showed that patients with no or a moderate cognitive impairment received 50% more prehospital pain medication than patients with a severe cognitive impairment. FICB was well tolerated in patients with hip fractures. Conclusion Fascia iliaca compartment block given to patients with hip fractures did not affect cognitive status in this study. Patients with a cognitive impairment may receive inadequate pain relief after hip fracture and this discrimination needs to be addressed in further studies. Trial registration EudraCT number 2008–004303-59 date of registration: 2008-10-24.

show abstract

Section: Discussionmentioning

confidence: 67%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Fascia iliaca compartment block as a preoperative analgesic in elderly patients with hip fractures – effects on cognition

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

“…Supra-inguinal FICB is accessed via a minimal risk approach to block the femoral nerve, lateral femoral cutaneous nerve, and obturator nerve, with rapid onset and definite analgesic effect, which procedure the anesthetization of the anterior, lateral, and medial areas of the thigh [ 16 ]. Wennberg [ 28 ] et al reported that FICB effectively provided high-quality pain relief after THA.…”

Section: Discussionmentioning

confidence: 99%

Postoperative pain treatment with transmuscular quadratus lumborum block and fascia iliaca compartment block in patients undergoing total hip arthroplasty: a randomized controlled trial

et al. 2021

View full text Add to dashboard Cite

Background Patients often suffer moderate or even severe pain after total hip arthroplasty; such pain seriously affects early postoperative recovery. This study aimed to investigate the analgesic efficacy of ultrasound-guided transmuscular quadratus lumborum block combined with fascia iliaca compartment block for elderly patients undergoing total hip arthroplasty. Methods Fifty-four patients scheduled for total hip arthroplasty were included in this randomized controlled study. The patients were randomly assigned to receive only transmuscular quadratus lumborum block (group Q) or transmuscular quadratus lumborum block combined with fascia iliaca compartment block (group QF) with ultrasound guidance. Postoperatively in both groups, paracetamol 1 g was regularly administered at 6 h intervals and patient-controlled intravenous analgesia was administered. The primary outcome was cumulative sufentanil consumption via patient-controlled intravenous analgesia 24 h postoperatively. The secondary outcomes included pain degree, time to the first analgesic requirement, joint range of motion, quality of recovery, and the incidence of postoperative complications. Results Fifty patients were included, and their data were analyzed. The cumulative sufentanil consumption in group QF was significantly lower during the first 24 h after surgery than that in group Q, and the cumulative sufentanil consumption in group QF was reduced at 6–12 and 12–18 h after surgery. The postoperative pain intensity was lower in group QF than in group Q (linear mixed-effects model, the main effect of treatment: P < 0.001). Compared with group Q, group QF had higher quality of recovery and joint range of movement. The time to the first analgesic requirement was longer in group QF than in group Q (log-rank, P < 0.001). There was no statistically significant difference in complications postoperatively between the two groups. Conclusions Our study provides a multimodal, opioid-sparing analgesic regimen for elderly patients undergoing total hip arthroplasty. The combination of transmuscular quadratus lumborum block and fascia iliaca compartment block provides a significant advantage for early postoperative functional recovery. Further studies are required to confirm the minimum effective dose. Trial registration The study was registered on the 21st December 2020 (retrospectively registered) on the Chinese Clinical Trial Registry: ChiCTR2000038686.

show abstract

“…Moreover, supra-inguinal FICB is accessed via a minimal risk approach to block the femoral nerve, lateral femoral cutaneous nerve, and obturator nerve, with rapid onset and de nite analgesic effect, which procedure the anesthetization of the anterior, lateral, and medial areas of the thigh [17] . Wennberg [28] et al reported that FICB effectively provided a high quality of pain relief after THA. Furthermore, although both sides seem to cover similar parts of the elds, T-QLB combined with FICB can optimize nerve block effects from block range and degree.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Pain Treatment with Transmuscular Quadratus Lumborum Block and Fascia Iliaca Compartment Block in Patients Undergoing Total Hip Arthroplasty: A Randomized Controlled Trial

Xia

Ding

Lin

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: Patients after total hip arthroplasty (THA) often suffered moderate or even severe pain, seriously affecting the early postoperative recovery. This study aimed to investigate the analgesic efficacy of ultrasound-guided transmuscular quadratus lumborum block (T-QLB) combined with fascia iliaca compartment block (FICB) for elderly patients undergoing THA.Methods: Sixty-four patients scheduled for THA were included in this randomized controlled study. The patients were divided into two groups: group Q and group QF. Before anesthesia induction, group Q was injected with 0.375% ropivacaine 40ml. In the QF group, T-QLB combined with FICB was injected with 0.375% ropivacaine 20ml, respectively. Paracetamol 1g regularly at 6 h intervals and patient-controlled intravenous analgesia (PCIA) were administrated in both groups postoperatively. The primary outcome was cumulative sufentanil consumption via PCIA on postoperative 24 h. The secondary outcomes included pain degree, time to the first analgesic requirement, range of motion, quality of recovery, and the incidence of postoperative complications.Results: Compared with the group Q, the cumulative sufentanil consumption were significantly lower in group QF at 6-12, 12-18, 18-24, and 24h (49.29±16.76 vs. 31.42±18.81μg, P <0.001) after surgery. The postoperative pain intensity was lower in group QF at rest after 6, 12, and 24 h (P <0.05) and at activity after 6, 12, 18, and 24 h (P <0.05). Group QF had higher Qor-15 scores at postoperative 24 h and 48 h (P <0.001) and longer duration before the first opioid require via PCIA (P <0.001) postoperatively than group Q. There was no statistically significant difference between the two groups for complications postoperatively of elderly.Conclusions: Our study provides a multimodal, opioid-sparing analgesic regimen for elderly patients in THA. The combination of T-QLB and FICB provides a significant advantage for early postoperative functional recovery. Further studies are required to confirm the minimum effective dose.Trial registration: Chinese Clinical Trial Registry(ChiCTR2000038686).

show abstract

Pre-operative pain management with nerve block in patients with hip fractures: a randomized, controlled trial

Cited by 18 publications

References 32 publications

Fascia iliaca compartment block as a preoperative analgesic in elderly patients with hip fractures – effects on cognition

Fascia iliaca compartment block as a preoperative analgesic in elderly patients with hip fractures – effects on cognition

Postoperative pain treatment with transmuscular quadratus lumborum block and fascia iliaca compartment block in patients undergoing total hip arthroplasty: a randomized controlled trial

Postoperative Pain Treatment with Transmuscular Quadratus Lumborum Block and Fascia Iliaca Compartment Block in Patients Undergoing Total Hip Arthroplasty: A Randomized Controlled Trial

Contact Info

Product

Resources

About