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Femoral neck fracture is very common in the elderly and can produce severe to moderate pain. As this pathology is not life-threatening, waiting time in the emergency department may be prolonged due to the high number of unforeseen cases with patients remaining in pain.
Fascia iliaca block consists of injecting local anaesthetics below the fascia iliaca, resulting in the anaesthesia of the femoral, the lateral cutaneous and the obturator nerves, with effective analgesia.
The objective of this trial is to compare the fascia iliaca block with a sham injection on patients arriving in the emergency department with a femoral neck fracture.
The fascia iliaca block will be performed with an anatomical landmark technique and a volume of 30 mLs of bupivacaine 0.5% with epinephrine 5 mcg/mL will be injected.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Fascia iliaca block | Experimental | Fascia iliaca block (Injection of 30 mLs of bupivacaine 0.5% with epinephrine 5 mcg/mL below the fascia iliaca, Carbostesin®) |
|
| Sham injection | Sham Comparator | No fascia iliaca block (Sham injection = Subcutaneous injection of 5 cc of normal saline, no intervention) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Fascia iliaca block | Procedure | injection of 30 mLs below the fascia iliaca |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Pain scores at rest | 45 minutes after the injection |
| Measure | Description | Time Frame |
|---|---|---|
| Pain scores at rest | 60 min, 4h, 8h, 12h, 24h after the injection | |
| Pain scores on movement | 60 min, 4h, 8h, 12h, 24h after the injection | |
| Morphine consumption |
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Inclusion Criteria:
- patients with femoral neck fracture in the emergency department
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Eric Albrecht, MD | Centre Hospitalier Universitaire Vaudois | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHUVaudois | Lausanne | Canton of Vaud | 1011 | Switzerland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33238043 | Derived | Guay J, Kopp S. Peripheral nerve blocks for hip fractures in adults. Cochrane Database Syst Rev. 2020 Nov 25;11(11):CD001159. doi: 10.1002/14651858.CD001159.pub3. | |
| 31262265 | Derived | Pasquier M, Taffe P, Hugli O, Borens O, Kirkham KR, Albrecht E. Fascia iliaca block in the emergency department for hip fracture: a randomized, controlled, double-blind trial. BMC Geriatr. 2019 Jul 1;19(1):180. doi: 10.1186/s12877-019-1193-0. |
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| ID | Term |
|---|---|
| D005265 | Femoral Neck Fractures |
| D000377 | Agnosia |
| ID | Term |
|---|---|
| D006620 | Hip Fractures |
| D005264 | Femoral Fractures |
| D050723 | Fractures, Bone |
| D014947 | Wounds and Injuries |
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| ID | Term |
|---|---|
| C005703 | salicylhydroxamic acid |
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| Sham injection |
| Procedure |
subcutaneous of 5 cc of normal saline |
|
| 60 min, 4h, 8h, 12h, 24h after the injection |
| Length of stay | up to 3 weeks |
| D025981 |
| Hip Injuries |
| D007869 | Leg Injuries |
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |