Continuous Fascia Iliaca Block for Acute Hip Fractures

Summary

Hip fractures are a major cause of morbidity and mortality in the elderly with over 30,000 hip fractures occuring in Canada annually and over 1300 in Saskatchewan. The estimated cost associated with hip fractures is over $600 million nationally and 28 million dollars in Saskatchewan. Hip fractures cause a great deal of pain and immobility and are mainly treated with surgical fixation. In the perioperative period, hip fracture patients are treated mainly with opioids and other adjuncts such as NSAIDS and acetaminophen. Opioid consumption in the elderly population can predispose to delirium and respiratory complications such as atelectasis, respiratory depression, and pneumonia.

Fascia iliaca blocks have been shown to be an effective mode of analgesia for patients with hip fractures, but are underutilized for varying reasons including culture of practice, expertise with performing the block, and having a dedicated service to do so.

This study aims to compare the efficacy of fascia iliaca blocks to standard treatment (opioids) in the management of pain in hip fracture patients with a particular focus on outcomes such as the incidence of delirium, respiratory complications, and length of stay in hospital. Our idea is that if we can reduce the amount of opioids these patients receive then they will have improved pain control, fewer respiratory complications, earlier time to mobilizing, and shorter hospital stays. As far as we are aware this relation has not been well studied.

Conditions

• Hip Fractures
• Neuromuscular Blockade
• Respiratory Morbidity
• Delirium
• Fascia Iliaca Block
• Pain

Interventions

PROCEDURE

Continuous fascia iliaca block

Regional nerve block performed under ultrasound guidance. A catheter will be left in place to allow ongoing infusion of local anesthetic.

DRUG

Ropivacaine

Ropivacaine local anesthetic will be used for the fascia iliaca block

Sponsors & Collaborators

• University of Saskatchewan

  lead OTHER

Principal Investigators

• Brian Brownbridge, MD · University of Saskatchewan

• Churao Yang, MD · University of Saskatchewan

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

65 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2018-05-07

Primary Completion

2019-03-31

Completion

2019-05-01

Countries

• Canada

Study Locations