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Figures
Fig. 1
Pain relief NRS.
Fig. 2
Participant flow diagram.
Fig. 3
Patient-reported pain with 95% confidence interval bars.
Abstract
Objectives
To compare pain relief between patients with intracapsular and extracapsular hip fractures who received an ultrasound-guided femoral nerve block (USFNB).
Design
A multicenter, prospective, randomized, clinical trial.
Setting
The study was conducted in the emergency departments of 3 academic hospitals located in New York City.
Subjects
Patients aged ≥60 years presenting to the emergency department with hip fracture.
Methods
A subgroup analysis from a larger data set was conducted of patients with intracapsular and extracapsular hip fractures who received an USFNB. We compared pain scores at baseline and then at 2 and 3 hours after the nerve block was performed, and also assessed pain relief at 2 and 3 hours.
Results
Seventy-seven patients were randomized to receive USFNB, of which 68 had follow-up data at 2 and 3 hours and were included in the data analysis. Thirty-one were diagnosed with intracapsular and 37 with extracapsular hip fractures. In both groups, reductions in pain scores were clinically and statistically significant. In the intracapsular group, mean pain scores decreased from 6.23 to 3.81 (P < .0001) at 2 hours and from 6.23 to 3.87 (P < .0001) at 3 hours. In the extracapsular group, mean pain scores decreased from 6.62 to 3.89 (P < .0001) at 2 hours and from 6.62 to 3.46 (P < .0001) at 3 hours. These differences were similar between the extracapsular and intracapsular groups at 2 hours (P = .92) and at 3 hours (P = .58), thus demonstrating similar reductions in pain in the 2 groups. The differences in pain relief between the intracapsular and extracapsular groups were also similar: 1.61 (confidence interval [CI], 1.14-2.08) vs 1.35 (CI, 0.96-1.75) at 2 hours (P = .39) and 1.68 (CI, 1.21-2.15) vs 1.38 (CI, 0.89-1.87) at 3 hours (P = .38).
Conclusion
Ultrasound-guided femoral nerve block was equally effective in reducing pain for patients with both intracapsular and extracapsular hip fractures.
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☆Financial support: The study was funded by grant from National Institute on Aging ( R01 AG030141-05 ).
☆☆Presentation of results: oral presentation at the SAEM Mid-Atlantic Regional meeting on February 28, 2015, in Washington, DC; oral presentation at New York ACEP on July 7, 2015, in Sagamore, NY.
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