Efficacy of Ultrasound–Guided Fascia Iliaca Block for Reducing Post–operative Pain after Hip Fracture Surgery in Elderly Patients at Sakon Nakhon hospital

Abstract

          Hip fracture occurs frequently in geriatric population and it increases the risk of death due to serious complications. Inappropriate post–operative pain management can cause major complication after surgery. Opioids and NSAIDs are drugs of choice for pain relief but these drugscan cause unpleasant side effects. The aim of this study was to evaluate the efficacy of ultrasound–guided Fascia iliaca block in reducing post–operative pain and opioids consumption after hip fracture surgery in elderly patients. Elderly patients aged between 60 – 85 years old who scheduled for hip fracture surgery were enrolled in this prospective randomized controlled trial study.

        The study included 32 patients in which 4 patients were dropped out, and then divided into 2 groups; 14 patients in Fascia iliaca block group and 14 patients in control group. The study showed that Fascia iliaca block significantly reduced postoperative pain score during rest and movement at 12 and 24 hours after the surgery (p–value < 0.001). Morphine consumption amount at 12 hour in Fascia iliaca block group (2.29 ± 2.59 mg) was significantly lower compared with control group (7.79 ± 4.06 mg) (p–value < 0.001). Moreover, morphine consumption amount at 24 hour in Fascia iliaca block group (4.14 ± 3.01 mg) was significantly lower compared with control group (11.79 ± 5.77 mg) (p–value < 0.001). Thus, Fascia iliaca block is an effective analgesic option for elderly patients with hip fracture in reducing 12 and 24–hours post–operative pain and opioids consumption.

            Keywords: Fascia iliaca block, Geriatric hip fracture, Post–operative pain