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This study aims to compare iliopsoas nerve Block (IPB) to femoral nerve block (FNB) regarding pain control, patient satisfaction, and early ambulation in patients undergoing hip fracture surgeries
Hip fractures are among the most frequent fractures seen in the emergency department and orthopedic trauma teams. The terms hip fracture and neck of femur fracture are used synonymously. Both terms describe a proximal femur fracture between the femoral head and 5 cm distal to the lesser trochanter.
Iliopsoas nerve Block (IPB) is a promising motor-sparing analgesic technique that selectively targets the sensory branches of the hip joint originating from the femoral nerve and accessory obturator nerve, sparing the motor supply of quadriceps muscles.
A femoral nerve block (FNB) is a simple nerve block that can be performed easily without or under ultrasound guidance. Under ultrasound guidance, the femoral artery and femoral nerve were identified clearly, and a needle was inserted using an in-plane approach from the lateral to the medial direction. Once the needle tip's position was confirmed, 10 ml of 0.5% bupivacaine was injected adjacent to the femoral nerve.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Iliopsoas nerve block group | Patients will receive an Iliopsoas nerve block using 10 ml of bupivacaine 0.5%. |
| |
| Femoral nerve block group | Patients will receive femoral nerve block using 10 ml of bupivacaine 0.5%. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Iliopsoas nerve block | Drug | Patients will receive an Iliopsoas nerve block using 10 ml of bupivacaine 0.5%. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Degree of pain | Each patient will be instructed about postoperative pain assessment with the numeric rating scale (NRS) score. NRS (0 represents "no pain" while 10 represents "the worst pain imaginable"). NRS will be assessed upon arrival at the post-anesthesia care unit (PACU) and at 2, 4, 6,12, 24 post-surgery. | 24 hours postoperatively |
| Measure | Description | Time Frame |
|---|---|---|
| Total opioids consumption | Intravenous pethidine (25mg) will be given to be repeated after 15 min if no response up to a maximum dose of 50 mg In case of moderate to sever pain. | 24 hours postoperatively |
| Assessment of quadriceps strength |
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Inclusion Criteria:
Exclusion Criteria:
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This prospective, single-blind cohort study will be conducted on 80 patients scheduled for elective surgical correction of hip fracture after obtaining approval from the Research Ethical Committee of Ain Shams University. It will be conducted in the assembled operation rooms in Ain Shams University Hospitals.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Hazem K Saeed, Master | Contact | 00201016056123 | hazem.khaled@med.asu.edu.eg |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ain Shams University | Recruiting | Cairo | 11591 | Egypt |
The data will be available upon a reasonable request from the corresponding author after the end of study for one year.
After the end of study for one year.
The data will be available upon a reasonable request from the corresponding author.
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| Femoral nerve block | Drug | Patients will receive femoral nerve block using 10 ml of bupivacaine 0.5%. |
|
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The quadriceps strength will be assessed using the manual muscle testing (MMT) grade (0-5; 0: no muscle contraction, 1: muscle contraction present but unable move joint, 2: able to move joint but not resist gravity, 3: able to resist gravity but not bear substantial resistance, 4: able to resist some level of substantial resistance, 5: able to resist full resistance).
| 24 hours postoperatively |
| Time of ambulation | Time of ambulation will be recorded from the end of surgery till walking or moving from place to place | 24 hours postoperatively |
| Patients' satisfaction | Degree of patient satisfaction will be assessed on a 5-point Likert scale patient satisfaction (1, extremely dissatisfied; 2, unsatisfied; 3, neutral; 4, satisfied; 5, extremely satisfied) | 24 hours postoperatively |
| Incidence of complications | Any complication will be recorded. | 24 hours postoperatively |