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Femoral Nerve Block Intervention in Neck of Femur Fracture (FINOF): a randomized controlled trial

Rowlands, Martin; Walt, Gerrie van de; Bradley, Jim; Mannings, Alexa; Armstrong, Sarah; Bedforth, Nigel M.; Moppett, Iain K.; Sahota, Opinder

Femoral Nerve Block Intervention in Neck of Femur Fracture (FINOF): a randomized controlled trial Thumbnail


Authors

Martin Rowlands

Gerrie van de Walt

Jim Bradley

Alexa Mannings

Sarah Armstrong

Nigel M. Bedforth

IAIN MOPPETT iain.moppett@nottingham.ac.uk
Professor of Anaesthesia and Perioperative Medicine

Opinder Sahota



Abstract

Objective

Fractured neck of femur is a severely painful condition with significant mortality and morbidity. We investigated whether early and continuous use of femoral nerve block can improve pain on movement and mobility after surgery in older participants with fragility neck of femur fracture.

Design

Prospective single centre, randomised controlled pragmatic trial.

Setting

Secondary care, acute NHS Trust, UK.

Participants

Participants admitted with a history and examination suggesting fractured neck of femur.

Intervention

Immediate continuous femoral nerve block via catheter or standard analgesia.

Results

One hundred and forty one participants were recruited, with 23 excluded. No significant difference was detected between cumulative dynamic pain scores (standard care (n = 56) vs 4
intervention (n = 55) 20 (IQR 15-24) vs 20 (15-23) p=0.51) or cumulated ambulation scores (standard care vs intervention 6 (5-9) vs 7 (5-10) p=0.76). There were no statistically different differences in secondary outcomes except cumulative pain at rest: 5 (0.5-6.5) in the standard care group and 2 (0-5) in the intervention group (p=0.043).

Conclusions

Early application of continuous femoral nerve block compared with standard systemic analgesia did not result in improved dynamic pain scores or superior post-operative ambulation. This technique may provide superior pain relief at rest. Continuous femoral nerve block did not delay initial control of pain, or mobilisation after surgery.

Citation

Rowlands, M., Walt, G. V. D., Bradley, J., Mannings, A., Armstrong, S., Bedforth, N. M., …Sahota, O. (2018). Femoral Nerve Block Intervention in Neck of Femur Fracture (FINOF): a randomized controlled trial. BMJ Open, 8(4), Article e019650. https://doi.org/10.1136/bmjopen-2017-019650

Journal Article Type Article
Acceptance Date Feb 2, 2018
Publication Date Apr 10, 2018
Deposit Date Mar 5, 2018
Publicly Available Date Mar 28, 2024
Journal BMJ Open
Electronic ISSN 2044-6055
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 8
Issue 4
Article Number e019650
DOI https://doi.org/10.1136/bmjopen-2017-019650
Keywords Femoral nerve block; Hip fracture; Regional anaesthesia; Pain control; Older people
Public URL https://nottingham-repository.worktribe.com/output/924586
Publisher URL http://bmjopen.bmj.com/content/8/4/e019650
Related Public URLs https://creativecommons.org/licenses/by-nc/4.0/