OBJECTIVES: The primary objective of this study was to determine the feasibility of ultrasound-guided femoral nerve blocks in elderly patients with hip fractures in the emergency department (ED). The secondary objective was to examine the effectiveness of this technique as an adjunct for pain control in the ED. METHODS: This prospective observational study enrolled a convenience sample of 13 patients with hip fractures. Ultrasound-guided femoral nerve block was performed on all participants. To determine feasibility, time to perform the procedure, number of attempts, and complications were measured. To determine effectiveness of pain control, numerical rating scores were assessed at baseline and at 15 minutes, 30 minutes, and hourly after the procedure for 4 hours. Summary statistics were calculated for feasibility measures. Wilcoxon matched-pairs signed-rank tests and Friedman analysis of variance test were used to compare differences in pain scores. RESULTS: The median age of the participants was 82 years (range, 67-94 years); 9 were female. The median time to perform the procedure was 8 minutes (range, 7-11 minutes). All procedures required only one attempt; there were no complications. After the procedure, there were 44% and 67% relative decreases in pain scores at 15 minutes (P < or = .002) and at 30 minutes (P < or = .001), respectively. Pain scores were unchanged from 30 minutes to 4 hours after the procedure (P < or = .77). CONCLUSIONS: Ultrasound-guided femoral nerve blocks are feasible to perform in the ED. Significant and sustained decreases in pain scores were achieved with this technique.
OBJECTIVES: The primary objective of this study was to determine the feasibility of ultrasound-guided femoral nerve blocks in elderly patients with hip fractures in the emergency department (ED). The secondary objective was to examine the effectiveness of this technique as an adjunct for pain control in the ED. METHODS: This prospective observational study enrolled a convenience sample of 13 patients with hip fractures. Ultrasound-guided femoral nerve block was performed on all participants. To determine feasibility, time to perform the procedure, number of attempts, and complications were measured. To determine effectiveness of pain control, numerical rating scores were assessed at baseline and at 15 minutes, 30 minutes, and hourly after the procedure for 4 hours. Summary statistics were calculated for feasibility measures. Wilcoxon matched-pairs signed-rank tests and Friedman analysis of variance test were used to compare differences in pain scores. RESULTS: The median age of the participants was 82 years (range, 67-94 years); 9 were female. The median time to perform the procedure was 8 minutes (range, 7-11 minutes). All procedures required only one attempt; there were no complications. After the procedure, there were 44% and 67% relative decreases in pain scores at 15 minutes (P < or = .002) and at 30 minutes (P < or = .001), respectively. Pain scores were unchanged from 30 minutes to 4 hours after the procedure (P < or = .77). CONCLUSIONS: Ultrasound-guided femoral nerve blocks are feasible to perform in the ED. Significant and sustained decreases in pain scores were achieved with this technique.
Authors: Anirudh Ramachandran; Michelle Montenegro; Maninder Singh; Trevor Dixon; Waqas Kayani; Timothy Liang; Nick Yu; Srinivas Reddy; Anna Liveris; Mallika Manyapu; Alyssia A McEwan; Vincent T Nguyen; Nechama V Sonenthal; Jill Corbo; Benjamin W Friedman; Jeremy Sperling; Michael P Jones; Michael Halperin Journal: Clin Exp Emerg Med Date: 2022-09-20
Authors: Jacques Simon Lee; Tina Bhandari; Robert Simard; Marcel Emond; Claude Topping; Michael Woo; Jeffrey Perry; Debra Eagles; Andrew D McRae; Eddy Lang; Charles Wong; Marco Sivilotti; Joseph Newbigging; Bjug Borgundvaag; Shelley L McLeod; Donald Melady; Lan Chernoff; Alex Kiss; Jordan Chenkin Journal: BMJ Open Date: 2021-07-05 Impact factor: 2.692