{"pk":9254,"title":"Single Fascia Iliaca Compartment Block is Safe and Effective for Emergency Pain Relief in Hip-fracture Patients","subtitle":null,"abstract":"Introduction: \nCurrently, it is common practice in the emergency department (ED) for pain relief in hip-fracture patients to administer pain medication, commonly systemic opioids. However, with these pain medications come a high risk of side effects, especially in elderly patients. This study investigated the safety profile and success rate of fascia iliaca compartment block (FICB) in a busy ED. This ED was staffed with emergency physicians (EPs) and residents of varying levels of experience. This study followed patients’ pain levels at various hourly intervals up to eight hours post procedure.\nMethods: \nBetween September 2012 and July 2013, we performed a prospective pilot study on hip-fracture patients who were admitted to the ED of a teaching hospital in the Netherlands. These patients were followed and evaluated post FICB for pain relief. Secondary outcome was the use of opioids as rescue medication.\nResults: \nOf the 43 patients in this study, patients overall experienced less pain after the FICB (p=0.04). This reduction in pain was studied in conjunction with the use and non-use of opioids. A clinically meaningful decrease in pain was achieved after 30 minutes in 62% of patients (54% with the use of opioids, 8% without opioids); after 240 minutes in 82% of patients (18% with opioids, 64% without opioids); after 480 minutes in 88% of patients (16% with opioids, 72% without opioids). No adverse events were reported.\nConclusion: \nIn a busy Dutch ED with rotating residents of varying levels of experience, FICB seems to be an efficient, safe and practical method for pain reduction in patients with a hip fracture. Even without the use of opioids, pain reduction was achieved in 64% of patients after four hours and in 72% of patients after eight hours.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"fascia iliaca compartment block"},{"word":"pain management"},{"word":"hip fracture"},{"word":"Analgesia"},{"word":"Emergency Medicine"}],"section":"Diagnostic Acumen","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8z80z14p","frozenauthors":[{"first_name":"Leonieke","middle_name":"","last_name":"Groot","name_suffix":"","institution":"Onze Lieve Vrouwe Gasthuis, Department of Emergency Medicine, Amsterdam, Netherlands","department":"None"},{"first_name":"Lea","middle_name":"M.","last_name":"Dijksman","name_suffix":"","institution":"Onze Lieve Vrouwe Gasthuis, Department of Emergency Medicine, Amsterdam, Netherlands","department":"None"},{"first_name":"Maarten","middle_name":"Peter","last_name":"Simons","name_suffix":"","institution":"Onze Lieve Vrouwe Gasthuis, Department of Emergency Medicine, Amsterdam, Netherlands","department":"None"},{"first_name":"Mariska","middle_name":"M.S","last_name":"Zwartsenburg","name_suffix":"","institution":"Onze Lieve Vrouwe Gasthuis, Department of Emergency Medicine, Amsterdam, Netherlands","department":"None"},{"first_name":"Jasper","middle_name":"R.","last_name":"Rebel","name_suffix":"","institution":"Onze Lieve Vrouwe Gasthuis, Department of Emergency Medicine, Amsterdam, Netherlands","department":"None"}],"date_submitted":"2015-07-23T09:54:32Z","date_accepted":"2015-07-23T09:54:32Z","date_published":"2015-12-14T23:26:50Z","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/9254/galley/5229/download/"}]}