PENG vs. FIC Blocks in Hip Fractures in the ED

Pericapsular Nerve Group (PENG) Block vs. the Fascia Iliaca Compartment (FIC) Block for Patients With Isolated Hip Fractures in the Emergency Department

This study is a prospective, randomized clinical trial assessing the efficacy of physician-performed ultrasound-guided pericapsular nerve group (PENG) block vs fascia iliaca compartment (FIC) block for pain control in acute hip fracture.

Inclusion Criteria:

• Adult (>= 18 years of age)
• Isolated proximal hip fracture (defined as Intertrochanteric or more proximal) as identified by X-ray, Computed Tomography (CT) scan or Magnetic Resonance Imaging (MRI) scan
• Glasgow Coma Score (GCS) = 15
• Subjective pain score of >= 5 on a scale of 0 to 10 just prior to the nerve block placement

Exclusion Criteria:

• Patients who are unable to give consent due to altered mental status or dementia
• Clinically intoxicated patients
• Patients who are unable to communicate their numeric level of pain
• Open fracture or penetrating hip trauma
• Signs of infection or laceration at injection site
• Patients with multi-system trauma
• Painful distracting injury (injury causing significant pain that distracts the patient from having reliable scoring of hip fracture pain, e.g. humerus fracture, dislocated joint)
• Requiring immediate surgical intervention (< 1 hour)
• Deemed clinically unstable by treating physician
• Abnormal vital signs (Pulse>120bpm, Systolic blood pressure < 100 mm Hg, Pulse O2 < 95%)
• Patients on long-acting systemic opioid analgesia
• Allergy to amide local anesthetics
• Vulnerable populations including pregnant patients, prisoners, children, elderly dementia patients. All precautions will be taken to avoid coercion, harm and exploitation of these vulnerable populations, thus they are to be excluded from this study. They will receive pain medications as deemed appropriate by their treating physician.