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Fascia iliaca compartment block performed by junior registrars as a supplement to pre-operative analgesia for patients with hip fracture.

Høgh A, Dremstrup L, Jensen SS, Lindholt J - Strategies Trauma Limb Reconstr (2008)

Bottom Line: This decreased to a median of 1.5 (SD = 0.78) 15 min post-block (P < 0.001) and 1.3 (SD = 0.71) 60 min post-block (P = 0.021).No side-effects were observed.There was no correlation between the number of FIB previously performed by the attending registrar and the improved maximal hip flexion (rho = 0.090, P = 0.50) or reduction in subjective pain score (rho = 0.005, P = 0.971).

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Viborg District Hospital, Viborg, Denmark, a_l_hogh@yahoo.dk.

ABSTRACT
This study investigate the efficacy of pre-operative pain treatment for patients with hip fractures using fascia lliaca compartment block (FIB) technique performed by junior registrars (JR) as a supplement to conventional pain treatment. The FIB technique has routinely been used pre-operatively in the emergency department since 1 January 2004 for all patients with hip fractures. Over an 8-month period, 187 patients were treated. FIB was performed with 40 ml lidocaine and bubivacaine. A simple 5-step verbal pain score and maximal passive hip flexion was used as objective and subjective pain measurements. Effect of FIB was prospectively assessed on 70 patients: 2/3 females, mean age 80.7 (SD = 7.8), 36% in ASA-group III and IV (95% CI, 0.25-0.48). The median pain-free hip flexion pre-block was 15 degrees (SD = 17) this improved to a median of 28 degrees (SD = 21) 15 min post-block (P = 0.014) and 37 degrees (SD = 26) 60 min post-block (P = 0.030). The median simple verbal pain score (0-4) pre-block was 2.2 (SD = 0.92). This decreased to a median of 1.5 (SD = 0.78) 15 min post-block (P < 0.001) and 1.3 (SD = 0.71) 60 min post-block (P = 0.021). No side-effects were observed. There was no correlation between the number of FIB previously performed by the attending registrar and the improved maximal hip flexion (rho = 0.090, P = 0.50) or reduction in subjective pain score (rho = 0.005, P = 0.971). FIB performed by JR is a feasible, efficient pre-operative supplement to conventional pain-treatment for patients with hip fractures. FIB is easy to perform, requires minimal introduction, no expensive equipment and is connected with a minimal risk approach.

No MeSH data available.


Related in: MedlinePlus

Correlation between improved maximal hip flexion after fascia iliaca compartment block (FIB) application and the number of FIB previously performed. Scale for numbers of FIB previously performed by the treating doctors. 0, 0; 1, 1–4; 2, 5–9; 3, ≥10
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Fig5: Correlation between improved maximal hip flexion after fascia iliaca compartment block (FIB) application and the number of FIB previously performed. Scale for numbers of FIB previously performed by the treating doctors. 0, 0; 1, 1–4; 2, 5–9; 3, ≥10

Mentions: The administration of morphine prior to the FIB did not alter the efficacy of block. There was no correlation between the number of blocks previously performed by the attending registrar and the observed effect as evaluated by maximal hip flexion (ρ = 0.090, P = 0.50) and subjective pain score (ρ = 0.005, P = 0.971) (see Fig. 5).Fig. 5


Fascia iliaca compartment block performed by junior registrars as a supplement to pre-operative analgesia for patients with hip fracture.

Høgh A, Dremstrup L, Jensen SS, Lindholt J - Strategies Trauma Limb Reconstr (2008)

Correlation between improved maximal hip flexion after fascia iliaca compartment block (FIB) application and the number of FIB previously performed. Scale for numbers of FIB previously performed by the treating doctors. 0, 0; 1, 1–4; 2, 5–9; 3, ≥10
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2553430&req=5

Fig5: Correlation between improved maximal hip flexion after fascia iliaca compartment block (FIB) application and the number of FIB previously performed. Scale for numbers of FIB previously performed by the treating doctors. 0, 0; 1, 1–4; 2, 5–9; 3, ≥10
Mentions: The administration of morphine prior to the FIB did not alter the efficacy of block. There was no correlation between the number of blocks previously performed by the attending registrar and the observed effect as evaluated by maximal hip flexion (ρ = 0.090, P = 0.50) and subjective pain score (ρ = 0.005, P = 0.971) (see Fig. 5).Fig. 5

Bottom Line: This decreased to a median of 1.5 (SD = 0.78) 15 min post-block (P < 0.001) and 1.3 (SD = 0.71) 60 min post-block (P = 0.021).No side-effects were observed.There was no correlation between the number of FIB previously performed by the attending registrar and the improved maximal hip flexion (rho = 0.090, P = 0.50) or reduction in subjective pain score (rho = 0.005, P = 0.971).

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Viborg District Hospital, Viborg, Denmark, a_l_hogh@yahoo.dk.

ABSTRACT
This study investigate the efficacy of pre-operative pain treatment for patients with hip fractures using fascia lliaca compartment block (FIB) technique performed by junior registrars (JR) as a supplement to conventional pain treatment. The FIB technique has routinely been used pre-operatively in the emergency department since 1 January 2004 for all patients with hip fractures. Over an 8-month period, 187 patients were treated. FIB was performed with 40 ml lidocaine and bubivacaine. A simple 5-step verbal pain score and maximal passive hip flexion was used as objective and subjective pain measurements. Effect of FIB was prospectively assessed on 70 patients: 2/3 females, mean age 80.7 (SD = 7.8), 36% in ASA-group III and IV (95% CI, 0.25-0.48). The median pain-free hip flexion pre-block was 15 degrees (SD = 17) this improved to a median of 28 degrees (SD = 21) 15 min post-block (P = 0.014) and 37 degrees (SD = 26) 60 min post-block (P = 0.030). The median simple verbal pain score (0-4) pre-block was 2.2 (SD = 0.92). This decreased to a median of 1.5 (SD = 0.78) 15 min post-block (P < 0.001) and 1.3 (SD = 0.71) 60 min post-block (P = 0.021). No side-effects were observed. There was no correlation between the number of FIB previously performed by the attending registrar and the improved maximal hip flexion (rho = 0.090, P = 0.50) or reduction in subjective pain score (rho = 0.005, P = 0.971). FIB performed by JR is a feasible, efficient pre-operative supplement to conventional pain-treatment for patients with hip fractures. FIB is easy to perform, requires minimal introduction, no expensive equipment and is connected with a minimal risk approach.

No MeSH data available.


Related in: MedlinePlus