Opioid Usage During Admission in Hip Fracture Patients—The Effect of the Continuous Femoral Nerve Block

• Published in: Geriatric orthopaedic surgery & rehabilitation Vol. 7; no. 4; pp. 197 - 201
• Main Authors: Helsø, Ida, Jantzen, Christopher, Lauritzen, Jes Bruun, Jørgensen, Henrik Løvendahl
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.12.2016; Sage Publications Ltd; SAGE Publishing
• Subjects: Fractures; Health risk assessment; Hospitalization; Morphine; Narcotics; Pain; mortality; continuous femoral nerve block; postoperative pain assessment; morphine consumption; hip fracture
• ISSN: 2151-4593; 2151-4585; 2151-4593
• DOI: 10.1177/2151458516672284

Introduction: The aim of this study was to investigate whether there was a difference in opioid usage during admission for hip fracture patients with continuous femoral nerve block (cFNB) when compared to patients nonfemoral nerve block (nFNB). Methods and Materials: Patients were identified from the local database on all hip fracture patients admitted to Bispebjerg University Hospital, Denmark. Four hundred fifty-six hip fracture patients were included during the period September 2008 to October 2010. Results: Three hundred sixty-six hip fracture patients had cFNB. The mean time with cFNB was 3.4 days. There were no significant differences in gender, length of stay, time to surgery, mortality rate, in-hospital falls, or resurgery rates during admission between the 2 groups. The nFNB group had an insignificant higher use of morphine as needed during the first 5 days of admission (nFNB: 53.1 mg, 95% confidence interval [CI]: 34.4-71.7; cFNB: 47.7 mg, 95% CI: 40.7-64.3; P = .54) and during the whole admission (cFNB: 34.3 mg, 95% CI: 23.2-45.5; cFNB: 30.3 mg, 95% CI: 26.6-33.0; P = .4). Some 8.47% of the total morphine consumption during admission was morphine as needed for the nFNB group and 9.89% for the cFNB group. Conclusion: Patients with cFNB did only have a marginally lower opioid usage during admission when compared to patients without the block, with no significance between the 2 groups. This could indicate that the cFNB is an ineffective analgesic strategy, especially in the postoperative period, but larger randomized studies are needed in order to clarify this.