RecruitingACTRN12609000526279

Ultrasound-guided femoral nerve block as a mode of analgesia in patients presenting with a hip fracture to the Emergency Department.

Ultrasound guided femoral nerve block using 1% ropivacaine as a method of pain control in patients who present to emergency with a fractured hip.

Sponsor

St Vincents

Enrollment

46 participants

Start Date

Apr 4, 2009

Study Type

Interventional

Conditions

Pain management in patients who have a radiological diagnosis of fractured neck of femur who present to the emergency department.

Summary

We are examining pain management in those patients who present to the emergency department with a fractured hip. Current practice in St Vincent's hospital emergency department is regular paracetamol and parenteral morphine. The POTENTIAL side effects of morphine are well known particularly in the older age group and include such effects as: drowsiness and/or confusion; nausea and vomiting; clinical significant slowing of breathing and lowering of blood pressure. Particular in those who receive significant amounts of morphine. Our aim is to show that patients who receive an ultrasound guided femoral nerve block AS PART OF their pain control management will require clinically significant less morphine than those who do not. In fact we are hoping to show these patients use 50% less morphine. If this is the case we will be supporting the idea of introducing ultrasound guided femoral nerve blocks to current clinical practice guidelines for managing pain in fractured hips.

Eligibility

Sex: Both males and femalesMin Age: 18 Yearss

Plain Language Summary

Simplified for easier understanding

This study is looking at whether using an ultrasound-guided nerve block (a targeted injection of local anaesthetic near the femoral nerve in the upper thigh) reduces the amount of morphine needed to control pain in patients who come to the emergency department with a broken hip. Hip fractures are extremely painful, and morphine can cause serious side effects in older patients, such as confusion and breathing problems. This procedure may provide better pain control with fewer risks. You may be eligible if: - You are 18 years or older - You have a confirmed broken hip (fractured neck of femur) on X-ray You may NOT be eligible if: - You are pregnant, breastfeeding, or of childbearing age and unwilling to use contraception - You are allergic to ropivacaine, paracetamol, or morphine - You are taking blood thinners or have a significant clotting problem - You have a skin infection at the injection site - You have known nerve damage in the femoral nerve area - You have severe liver disease - You have had a recent heart attack (within 3 months) or have heart block - You are unable to give consent yourself Talk to your doctor about whether this trial might be right for you.

This is a simplified summary. Always discuss eligibility with your doctor before enrolling in a clinical trial.

Print for Your Doctor Check Your Eligibility

Interested in this trial?

Get notified about updates and connect with the research team.

Interventions

An ultrasound guided femoral nerve block will be placed using 1% ropivacaine. We are testing it's ability to provide pain control for patients with fractured neck of femurs. Any emergency registrar o

An ultrasound guided femoral nerve block will be placed using 1% ropivacaine. We are testing it's ability to provide pain control for patients with fractured neck of femurs. Any emergency registrar or consultant who has been enlisted as an investigator and has undergone the training session is able to enrol patients and administer the block. After written informed consent has been obtained by the patient the groin area is prepared with sterile technique. An ultrasound vascular probe is placed to locate structures anatomically: the main structures being the femoral nerve itself, the femoral artery and vein, the fascia iliaca. Then under real time ultrasound guidance via an out of plane approach 15ml of 1% ropivacaine is injected around the femoral nerve as visualised. A two person technique is employed with the needle attached to the syringe of ropivacaine via a 90cm minimum volume extension set. There is the probe and needle operator and the an assistant injecting the anaesthetic. Digital pressure is then placed for 30 seconds just distal to the injection site. The entire procedure takes about 15 to 20 minutes. Objective measure of the nerve block is assessed at 30 minutes by testing sensation over the anterolateral aspect of the thigh.

Locations(1)

Australia

View Full Details on ANZCTR

For the most up-to-date information, visit the official listing.

Visit

ACTRN12609000526279