Does time to surgery for traumatic hip fracture impact the efficacy of fascia iliaca blocks? A brief report

Trauma Surgery & Acute Care Open

article

Kerrick Akinola¹  Kristin Salottolo²  Richard Meinig⁴  Landon Fine⁵  Robert M Madayag¹  Francie Ekengren⁶  Allen Tanner II⁷  David Bar-Or² 

[1] Trauma Services Department , St Anthony Hospital;Trauma Research , St Anthony Hospital & Medical Campus;Trauma Research , Penrose-St Francis Health Services;Orthopedic Services Department , Penrose-St. Francis Health Services;Orthopedics , Parker Adventist Hospital;Trauma Research , Wesley Medical Center;Trauma Services Department , Penrose-St. Francis Health Services;Trauma Research Department , Penrose Hospital

关键词: hip fracture;    delirium;   

DOI  :  10.1136/tsaco-2022-000970

学科分类：社会科学、人文和艺术（综合）

来源: BMJ Publishing Group

【 摘 要 】

Objectives Outcomes after traumatic hip fracture have shown to be significantly improved with timely surgical management. This study determined whether there were differences in efficacy of fascia iliaca compartment block (FICB) on pain outcomes in patients with hip fracture, once stratified by time to surgery.Methods24 hours (later surgery; n=143).Results FICB use was similar with earlier and later surgery (70.2% vs 76.2%), and there were no demographic differences by utilization of FICB, by time to surgery. In the earlier surgery group, preoperative pain was lower for patients with FICB versus no FICB (3.6 vs 4.5, p0.99) or OMEs (p=0.75 preoperative, p=0.91 postoperative). In the later surgery group, there was a nearly twofold reduction in preoperative OMEs with FICB than no FICB (25.5 mg vs 45.2 mg, p=0.04), with no differences for delirium (OR 4.21, p=0.18), pain scores (p=0.25 preoperative, p=0.27 postoperative), and postoperative OMEs (p=0.34).Conclusions Compared with systemic analgesia, FICB resulted in improved pain scores at the preoperative assessment among patients with earlier surgery, whereas FICB reduced opioid consumption over the preoperative period only when surgery was later than 24 hours from arrival.

【 授权许可】

CC BY-NC|CC BY|CC BY-NC-ND