Regional Nerve Blocks For Hip and Femoral Neck Fractures in the Emergency Department: A Systematic Review

CJEM
Brandon RitceyJeffrey J Perry

Abstract

Hip and femoral neck fractures are common in elderly patients, who are at an increased risk of complications if their pain is suboptimally managed. This systematic review seeks to determine if regional nerve blocks reduce pain, reduce the need for parenteral opiates, and reduce complications, compared to standard pain management with opiates, acetaminophen, or NSAIDs. Systematic review of MEDLINE, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials found 401 articles, of which nine were selected for inclusion. Randomized controlled trials including adult patients with a hip or femoral neck fracture (Population) who had a 3-in-1 femoral nerve block, traditional femoral nerve block, or fascia iliaca compartment block performed preoperatively (Intervention). Comparison must have been made with standard pain management with opiates, acetaminophen, or NSAIDs (Comparison) and outcomes must have included pain score reduction (Outcome). Eight out of nine studies concluded pain scores were improved with the regional nerve block compared to standard pain management. A significant reduction in parenteral opiate use was seen in five out of six studies. No patients suffered life-threatening complications related to the ne...Continue Reading

References

Nov 1, 1973·Anesthesia and Analgesia·A P WinnieZ Durrani
Jun 16, 2000·Journal of the American Geriatrics Society·E R MarcantonioN M Resnick
Feb 1, 2003·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·R Sean MorrisonAlbert L Siu
Mar 5, 2009·Regional Anesthesia and Pain Medicine·John DolanGavin N C Kenny
Aug 20, 2009·Journal of Orthopaedics and Traumatology : Official Journal of the Italian Society of Orthopaedics and Traumatology·George MouzopoulosMichalis Kaminaris
Jan 1, 2010·International Journal of Emergency Medicine·Daniel Godoy MonzónKenneth V Iserson
Aug 17, 2011·Annals of Internal Medicine·Ahmed M Abou-SettaC Allyson Jones
Oct 20, 2011·BMJ : British Medical Journal·Julian P T HigginsUNKNOWN Cochrane Statistical Methods Group
Feb 28, 2013·Emergency Medicine Journal : EMJ·Rajnish Mittal, Era Vermani
Jun 8, 2013·Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association·Yuki FujiharaShinichi Yoshiya
Jun 14, 2013·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Francesca L BeaudoinOtto Liebmann

❮ Previous
Next ❯

Citations

Apr 23, 2016·Journal of Orthopaedic Trauma·Anthony G Sanzone
Apr 25, 2017·The Western Journal of Emergency Medicine·Andrew GrockMichelle Lin
Oct 10, 2019·Acta Anaesthesiologica Scandinavica·C SkjoldK Wildgaard
Mar 7, 2017·Regional Anesthesia and Pain Medicine·Thomas D NielsenThomas Fichtner Bendtsen
Jan 27, 2019·Drugs & Aging·Carole LinBan C H Tsui
Nov 24, 2019·Emergency Medicine Clinics of North America·Phillip D MagidsonTeresita M Hogan
Feb 8, 2021·European Geriatric Medicine·Cristina Ojeda-ThiesLuis Rafael Ramos-Pascua
Mar 3, 2021·Archives of Orthopaedic and Trauma Surgery·Heather J RobertsUtku Kandemir
Nov 9, 2021·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Paul M JeziorczakCharles J Aprahamian

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.