Opioid Usage During Admission in Hip Fracture Patients—The Effect of the Continuous Femoral Nerve Block. (December 2016)

• Record Type: Journal Article
• Authors: Helsø, Ida; Jantzen, Christopher; Lauritzen, Jes Bruun; Jørgensen, Henrik Løvendahl
• Is Part Of: Geriatric orthopaedic surgery & rehabilitation. Volume 7:Number 4(2016:Dec.)
• Page Start: 197
• Page End: 201
• Publication Date: 2016-12
• Subjects: hip fracture -- continuous femoral nerve block -- morphine consumption -- postoperative pain assessment -- mortality; Older people -- Surgery -- Periodicals; Orthopedic surgery -- Periodicals; Geriatrics -- Rehabilitation -- Periodicals; 617.97
• DOI: 10.1177/2151458516672284
• Languages: English
• ISSNs: 2151-4585

Abstract

Introduction: The aim of this study was to investigate whether there was a difference in opioid usage during admission for hip fracture patients with continuous femoral nerve block (cFNB) when compared to patients nonfemoral nerve block (nFNB). Methods and Materials: Patients were identified from the local database on all hip fracture patients admitted to Bispebjerg University Hospital, Denmark. Four hundred fifty-six hip fracture patients were included during the period September 2008 to October 2010. Results: Three hundred sixty-six hip fracture patients had cFNB. The mean time with cFNB was 3.4 days. There were no significant differences in gender, length of stay, time to surgery, mortality rate, in-hospital falls, or resurgery rates during admission between the 2 groups. The nFNB group had an insignificant higher use of morphine as needed during the first 5 days of admission (nFNB: 53.1 mg, 95% confidence interval [CI]: 34.4-71.7; cFNB: 47.7 mg, 95% CI: 40.7-64.3; P = .54) and during the whole admission (cFNB: 34.3 mg, 95% CI: 23.2-45.5; cFNB: 30.3 mg, 95% CI: 26.6-33.0; P = .4). Some 8.47% of the total morphine consumption during admission was morphine as needed for the nFNB group and 9.89% for the cFNB group. Conclusion: Patients with cFNB did only have a marginally lower opioid usage during admission when compared to patients without the block, with no significance between the 2 groups. This could indicate that the cFNB is an ineffective analgesic strategy, especially in the postoperative period, but larger randomized studies are needed in order to clarify this.