Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
3
pubmed:dateCreated
2007-3-30
pubmed:abstractText
Hip fractures can cause considerable pain when untreated or under-treated. To enhance pain relief and diminish the risk of delirium from typically administered parenteral analgesics and continued pain, we tested the efficacy of using fascia-iliaca blocks (FICB), administered by one of four attending physicians working in the emergency department (ED), with commonly available ED equipment. After informed consent, a physician administered one FICB to 63 sequential adult ED patients (43 women, 20 men; ages 37-96 years, mean 73.5 years) with radiographically diagnosed hip fractures. Under aseptic conditions, a 21 g, 2-inch IM injection needle was inserted perpendicularly to the skin 1 cm below the juncture of the lateral and medial two-thirds of a line that joins the pubic tubercle to the anterior superior iliac spine. The needle was inserted until a loss of resistance was felt twice (fascia lata and fascia iliaca), at which point 0.3 mL/kg of 0.25 bupivacaine was infused. The physician tested the block's efficacy by assessing sensory loss. Pain assessments were done using a 10-point Likert Visual Analog Scale (VAS) before, and at 15 min, 2 h, and 8 h post-block. Block failure was having the same level of pain as before the block. Oral analgesics were administered as needed. The IRB approved this study. Post-procedure pain was reduced in all patients, but not completely abolished in any. Before the FICB, the pain ranged from 2 to 10 points (average 8.5) using the VAS; at 15 min post-injection, it ranged from 1 to 7 points (average 2.9); at 2 h post-injection, it ranged from 2 to 6 points (average 2.3); at 8 h post-injection, it ranged from 4 to 7 points (average 4.4). Analgesic requests in the first 24 h after admission averaged 1.2 doses (range 1 to 4 doses) of diclofenac 75 mg. There were no systemic complications and only two local hematomas. Resident physicians learned the procedure and could perform it successfully with less than 5 min instruction. Physicians rarely use the FICB in EDs, although the technique is simple to learn and use. This rapid, effective, and safe method of achieving excellent pain control in ED patients with hip fractures can be performed using standard ED equipment.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Apr
pubmed:issn
0736-4679
pubmed:author
pubmed:issnType
Print
pubmed:volume
32
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
257-62
pubmed:dateRevised
2011-11-17
pubmed:meshHeading
pubmed-meshheading:17394987-Adult, pubmed-meshheading:17394987-Aged, pubmed-meshheading:17394987-Aged, 80 and over, pubmed-meshheading:17394987-Anesthetics, Local, pubmed-meshheading:17394987-Bupivacaine, pubmed-meshheading:17394987-Emergency Service, Hospital, pubmed-meshheading:17394987-Fascia, pubmed-meshheading:17394987-Feasibility Studies, pubmed-meshheading:17394987-Female, pubmed-meshheading:17394987-Hip Fractures, pubmed-meshheading:17394987-Humans, pubmed-meshheading:17394987-Ilium, pubmed-meshheading:17394987-Male, pubmed-meshheading:17394987-Middle Aged, pubmed-meshheading:17394987-Nerve Block, pubmed-meshheading:17394987-Pain, pubmed-meshheading:17394987-Pain Management, pubmed-meshheading:17394987-Pain Measurement, pubmed-meshheading:17394987-Prospective Studies, pubmed-meshheading:17394987-Treatment Outcome
pubmed:year
2007
pubmed:articleTitle
Single fascia iliaca compartment block for post-hip fracture pain relief.
pubmed:affiliation
Servicio de Ortopedia y Traumatologia, Instituto Carlos E. Ottolenghi, Hospital Italiano, Buenos Aires, Argentina.
pubmed:publicationType
Journal Article