Peripheral Nerve Blocks in Elderly Patients With Hip Fracture

Shanghai Jiao Tong University

Status: Unknown

Conditions: Hip Fracture

Treatments: Procedure: Lumbar plexus and sacral plexus nerve block; Procedure: Femoral nerve and the lateral cutaneous nerve block

Study type: Interventional

Funder types: Other

Identifiers

NCT02635763

NB001

Details and patient eligibility

About

As the population ages, the frequency of surgery is increasing proportionally, bringing with it the challenge of managing older patients with frequent comorbid diseases and an increased risk of complications. Poor postoperative quality of recovery may result in patient and family suffering, a prolonged hospital stay, and a greater demand on health care resources.The purpose of this study was to evaluate the ultrasound guided percutaneous femoral nerve+lateral cutaneous nerve versus lumbar plexus+sacral plexus nerve block composite laryngeal mask anesthesia in elderly hip fracture surgery, the application of assessing their impact on the postoperative recovery quality.

Full description

In this study, patients who were more than 65 years old with hip fracture were randomized to peripheral nerve blocks 1(PNBs1)- femoral nerve+lateral cutaneous nerve-with laryngeal mask anesthesia, or peripheral nerve blocks 2(PNBs2) - lumbar plexus and sciatic - with laryngeal mask anesthesia. Blocks were performed using ultrasound and 0.5% ropivacaine. All patients received postoperative multimodal analgesia. Postoperative recovery was assessed at 15 minutes, 40 minutes,- 1 day, 3 days, and 7 days after surgery, with the Postoperative Quality of Recovery Scale, in physiological, nociceptive, emotive, modified activities of daily living, modified cognitive, and overall patient perspective domains.

Enrollment: 60 estimated patients

Sex: All

Ages: 65 to 85 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. ASA grade I ~ III level;
2. The BMI <30;
3. The Mini - getting the state examination MMSE > 23;
4. The operation type:open reduction and internal fixation or bipolar head replace.

Exclusion criteria

1. Serious systemic diseases such as respiratory dysfunction, cardiac insufficiency, and renal insufficiency;
2. Has a history of cognitive function disorder or mental illness;
3. Has a history of cerebral infarction and leave sequela;
4. The blood coagulation dysfunction;
5. The hearing or visual impairment;
6. Unable to complete assessment;
7. Operation time more than 90 minutes;
8. The bleeding is greater than 1000 ml.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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60 participants in 2 patient groups

PNBs1

Other group

Description:

Femoral nerve and the lateral cutaneous nerve block combined with general anesthesia

Treatment:

Procedure: Femoral nerve and the lateral cutaneous nerve block

PNBs2

Other group

Description:

Lumbar plexus and sacral plexus nerve block combined with general anesthesia

Treatment:

Procedure: Lumbar plexus and sacral plexus nerve block