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

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....

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Main Authors: Rowlands, Martin, Walt, Gerrie van de, Bradley, Jim, Mannings, Alexa, Armstrong, Sarah, Bedforth, Nigel M., Moppett, Iain K., Sahota, Opinder
Format: Article
Language:English
Published: BMJ Publishing Group Ltd 2018
Subjects:
Online Access:https://eprints.nottingham.ac.uk/50162/
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author Rowlands, Martin
Walt, Gerrie van de
Bradley, Jim
Mannings, Alexa
Armstrong, Sarah
Bedforth, Nigel M.
Moppett, Iain K.
Sahota, Opinder
author_facet Rowlands, Martin
Walt, Gerrie van de
Bradley, Jim
Mannings, Alexa
Armstrong, Sarah
Bedforth, Nigel M.
Moppett, Iain K.
Sahota, Opinder
author_sort Rowlands, Martin
building Nottingham Research Data Repository
collection Online Access
description 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.
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spelling nottingham-501622018-04-15T22:18:40Z https://eprints.nottingham.ac.uk/50162/ 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 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. BMJ Publishing Group Ltd 2018-04-10 Article PeerReviewed application/pdf en cc_by_nc https://eprints.nottingham.ac.uk/50162/8/e019650.full.pdf Rowlands, Martin, Walt, Gerrie van de, Bradley, Jim, Mannings, Alexa, Armstrong, Sarah, Bedforth, Nigel M., Moppett, Iain K. and Sahota, Opinder (2018) Femoral Nerve Block Intervention in Neck of Femur Fracture (FINOF): a randomized controlled trial. BMJ Open, 8 (4). e019650/1-e019650/8. ISSN 2044-6055 Femoral nerve block; Hip fracture; Regional anaesthesia; Pain control; Older people http://bmjopen.bmj.com/content/8/4/e019650 doi:10.1136/bmjopen-2017-019650 doi:10.1136/bmjopen-2017-019650
spellingShingle Femoral nerve block; Hip fracture; Regional anaesthesia; Pain control; Older people
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
title Femoral Nerve Block Intervention in Neck of Femur Fracture (FINOF): a randomized controlled trial
title_full Femoral Nerve Block Intervention in Neck of Femur Fracture (FINOF): a randomized controlled trial
title_fullStr Femoral Nerve Block Intervention in Neck of Femur Fracture (FINOF): a randomized controlled trial
title_full_unstemmed Femoral Nerve Block Intervention in Neck of Femur Fracture (FINOF): a randomized controlled trial
title_short Femoral Nerve Block Intervention in Neck of Femur Fracture (FINOF): a randomized controlled trial
title_sort femoral nerve block intervention in neck of femur fracture (finof): a randomized controlled trial
topic Femoral nerve block; Hip fracture; Regional anaesthesia; Pain control; Older people
url https://eprints.nottingham.ac.uk/50162/
https://eprints.nottingham.ac.uk/50162/
https://eprints.nottingham.ac.uk/50162/