%0 Journal Article
%T Analgesic efficacy of continuous femoral nerve block commenced prior to operative fixation of fractured neck of femur
%A Szilard Szucs
%A Gabriella Iohom
%A Brian O¡¯Donnell
%A Pavol Sajgalik
%A Ishtiaq Ahmad
%A Nazar Salah
%A George Shorten
%J Perioperative Medicine
%D 2012
%I BioMed Central
%R 10.1186/2047-0525-1-4
%X Following institutional ethical approval and with informed consent, patients awaiting FNF surgery were randomly allocated to receive either standard opiate-based analgesia (Group 1) or a femoral perineural catheter (Group 2). Patients in Group 1 received parenteral morphine as required. Those in Group 2 received a CFNB comprising a bolus of local anaesthetic followed by a continuous infusion of 0.25% bupivacaine. For both Groups, rescue analgesia consisted of intramuscular morphine as required and all patients received paracetamol regularly. Pain was assessed using a visual analogue scale at rest and during passive movement (dynamic pain score) at 30£¿min following first analgesic intervention and six hourly thereafter for 72 hours. Patient satisfaction with the analgesic regimen received was recorded using verbal rating scores (0-10). The primary outcome measured was dynamic pain score from initial analgesic intervention to 72 hours later.Of 27 recruited, 24 patients successfully completed the study protocol and underwent per protocol analysis. The intervals from recruitment to the study until surgery were similar in both groups [31.4(17.7) vs 27.5(14.2) h, P£¿=£¿0.57]. The groups were similar in terms of baseline clinical characteristics. For patients in Group 2, pain scores at rest were less than those reported by patients in Group 1 [9.5(9.4) vs 31(28), P£¿=£¿0.031]. Dynamic pain scores reported by patients in Group 2 were less at each time point from 30£¿min up to 54 hours [e.g at 6£¿h 30.7(23.4) vs 67.0(32.0), P£¿=£¿0.004]. Cumulative morphine consumption over 72£¿h was less in Group 2. Patient satisfaction scores were greater in Group 2 [9.4(1.1) vs 7.6(1.8), P£¿=£¿0.014].CFNB provides more effective perioperative analgesia than a standard opiate-based regimen for patients undergoing fixation of FNF. It is associated with lesser opiate use and greater patient satisfaction.Fractured neck of femur (FNF) is a common, painful reason for hospital admission in elderly patients
%K Perioperative pain relief
%K Hip fractured neck of femur
%K Continuous femoral nerve block
%U http://www.perioperativemedicinejournal.com/content/1/1/4