Not Yet RecruitingPhase 3ACTRN12618001884291

Better ways of pain management in adults with hip fractures

Neck Of Femur fracture pain management with ultrasound-guided single bolus versus repeated bolus Fascia Iliaca CatheterS in the Emergency Department: a double-blind, randomized controlled trial. (NOF-FICSED)

Sponsor

Townsville Hospital

Enrollment

122 participants

Start Date

Jul 1, 2019

Study Type

Interventional

Conditions

Cognitive Impairment Hip Fracture Pain Management

Summary

The purpose of this study is to compare ultrasound guided repeat fascia iliaca blocks delivered through a catheter to ultrasound guided single blocks delivered through a catheter with a saline control in emergency department hip fracture patients. The outcomes measured will be behavioural pain scores, verbal pain scores, opioid use, and incidence of delirium. Further a health economic component will analyse cost effectiveness of both interventions. We predict based on the literature and a pilot study that repeated boluses will be less painful, use less opioids, and have decreased incidences of delirium.

Eligibility

Sex: Both males and femalesMin Age: 50 Yearss

Inclusion Criteria1

Adults over the age of 50 years with a radiologically-proven neck of femur fracture and ability to consent

Exclusion Criteria8

Interhospital transfers,
Refusal of consent,
Individuals with weights less than 50kg, Local site infection,
Allergies to local anaesthetics,
Liver failure,
Dangerous or combative patients,
Altered anatomy (such as past femoral bypass),
Unwell patients requiring immediate resuscitation

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Interventions

Single vs repeated bolus fascia iliaca (FICB) nerve blocks from emergency department to surgery. Arm 1: 40ml 0.2% Ropivacaine through a FICB catheter followed by 2hrly 20ml 0.2% Ropivacaine through

Single vs repeated bolus fascia iliaca (FICB) nerve blocks from emergency department to surgery. Arm 1: 40ml 0.2% Ropivacaine through a FICB catheter followed by 2hrly 20ml 0.2% Ropivacaine through the same FICB catheter until surgery. This duration maybe anywhere from 6 - 48 hours. Arm 2: 40ml 0.2% Ropivacaine through a FICB catheter followed by 2hrly 20ml 0.9% saline through the same FICB catheter until surgery. This duration maybe anywhere from 6 - 48 hours.