scholarly journals Ultrasound‑guided continuous fascia iliaca compartment block for pre‑operative pain control in very elderly patients with hip fracture: A randomized controlled trial

2018 ◽  
Author(s):  
Yanhui Ma ◽  
Jie Wu ◽  
Jixiu Xue ◽  
Fei Lan ◽  
Tianlong Wang
Keyword(s):  
Randomized Controlled Trial ◽  
Hip Fracture ◽  
Elderly Patients ◽  
Pain Control ◽  
Controlled Trial ◽  
Ultrasound Guided ◽  
Very Elderly ◽  
Randomized Controlled ◽  
Fascia Iliaca Compartment Block

Reduction of Postoperative Hip Arthroscopy Pain With an Ultrasound-Guided Fascia Iliaca Block: A Prospective Randomized Controlled Trial

2020 ◽  
Vol 48 (3) ◽  
pp. 682-688 ◽  
Author(s):  
John L. Glomset ◽  
Eugene Kim ◽  
John M. Tokish ◽  
Suzanne D. Renfro ◽  
Tyler B. Seckel ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Hip Arthroscopy ◽  
Pain Control ◽  
Recovery Time ◽  
Controlled Trial ◽  
Postoperative Nausea And Vomiting ◽  
Ultrasound Guided ◽  
Readmission Rates ◽  
Randomized Controlled ◽  
Fascia Iliaca Block

Background: Ultrasound-guided fascia iliaca blocks have been used for pain control after hip arthroscopy. There is little evidence regarding their effectiveness in comparison with other pain control modalities in patients who have undergone hip arthroscopy. Purpose: To compare the efficacy of ultrasound-guided fascia iliac block with intra-articular ropivacaine in controlling pain after hip arthroscopy. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: Between 2015 and 2017, patients (N = 95) undergoing hip arthroscopy were randomly assigned to 2 groups. The first group received an ultrasound-guided fascia iliaca block with 50 to 60 mL of 0.35% ropivacaine. The second group received an intra-articular injection of 20 mL of 0.5% ropivacaine at the completion of the surgical case. Primary outcomes were postoperative pain scores in the recovery room; at postanesthesia care unit (PACU) discharge; and at 2 weeks, 6 weeks, and 3 months. Secondary outcomes included intraoperative and PACU narcotic usage (converted to morphine equivalent use) as well as readmission rates, PACU recovery time, and postoperative nausea and vomiting. Results: Postoperative pain across all points did not significantly differ between the groups. Intraoperative and PACU narcotics did not differ significantly between the groups. Readmission rates, PACU recovery time, and postoperative nausea and vomiting did not significantly differ between the groups. There were no associated complications in either group. Conclusion: Ultrasound-guided fascia iliaca block for hip arthroscopy had no clinical advantage when compared with onetime intra-articular ropivacaine injection. Registration: NCT02365961 (ClinicalTrials.gov identifier).

Single dose of tranexamic acid effectively reduces blood loss and transfusion rates in elderly patients undergoing surgery for hip fracture: a randomized controlled trial

2021 ◽  
Vol 103-B (3) ◽  
pp. 442-448
Author(s):  
Vasileios S. Nikolaou ◽  
Panagiotis Masouros ◽  
Themistoklis Floros ◽  
Efstathios Chronopoulos ◽  
Maria Skertsou ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Single Dose ◽  
Hip Fracture ◽  
Blood Loss ◽  
Elderly Patients ◽  
Tranexamic Acid ◽  
Controlled Trial ◽  
Total Blood ◽  
Subcapital Fracture ◽  
Randomized Controlled

Aims The aim of this study was to investigate the hypothesis that a single dose of tranexamic acid (TXA) would reduce blood loss and transfusion rates in elderly patients undergoing surgery for a subcapital or intertrochanteric (IT) fracture of the hip. Methods In this single-centre, randomized controlled trial, elderly patients undergoing surgery for a hip fracture, either hemiarthroplasty for a subcapital fracture or intramedullary nailing for an IT fracture, were screened for inclusion. Patients were randomly allocated to a study group using a sealed envelope. The TXA group consisted of 77 patients, (35 with a subcapital fracture and 42 with an IT fracture), and the control group consisted of 88 patients (29 with a subcapital fracture and 59 with an IT fracture). One dose of 15 mg/kg of intravenous (IV) TXA diluted in 100 ml normal saline (NS,) or one dose of IV placebo 100 ml NS were administered before the incision was made. The haemoglobin (Hb) concentration was measured before surgery and daily until the fourth postoperative day. The primary outcomes were the total blood loss and the rate of transfusion from the time of surgery to the fourth postoperative day. Results Homogeneity with respect to baseline characteristics was ensured between groups. The mean total blood loss was significantly lower in patients who received TXA (902.4 ml (-279.9 to 2,156.9) vs 1,226.3 ml (-269.7 to 3,429.7); p = 0.003), while the likelihood of requiring a transfusion of at least one unit of red blood cells was reduced by 22%. Subgroup analysis showed that these differences were larger in patients who had an IT fracture compared with those who had a subcapital fracture. Conclusion Elderly patients who undergo intramedullary nailing for an IT fracture can benefit from a single dose of 15 mg/kg TXA before the onset of surgery. A similar tendency was identified in patients undergoing hemiarthroplasty for a subcapital fracture but not to a statistically significant level. Cite this article: Bone Joint J 2021;103-B(3):442–448.

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