Effect of comorbidities and postoperative complications on mortality after hip fracture in elderly people: prospective observational cohort study.
J J W Roche, R T Wenn, O Sahota...
https://pubmed.ncbi.nlm.nih.gov/16299013Actively Recruiting
Phase Not Applicable
Age: 60Years +
All Genders
ID05660603
Circum-Psoas Blocks Versus Combined Lumbar and Sacral Plexus Blocks for Sensory Level and Postoperative Analgesia in Hip Fracture Surgery
Led by Zagazig University · Updated on 2025-07-17
63
Participants Needed
1
Research Sites
8 weeks
Total Duration
On this page
AI-Summary
What this Trial Is About
Hip fractures are a significant global health issue for older adults, with high mortality rates and serious impacts on independence and quality of life. Surgical treatment is the preferred option for hip fractures in the elderly, but it often causes moderate to severe pain after surgery. Effective pain management and early rehabilitation are crucial for recovery, reducing hospital stay, and improving mobility. This trial explores new approaches to pain relief after hip fracture surgery, comparing two nerve block techniques to find better pain control methods under general anesthesia. The study compares ultrasound-guided circum-psoas block and combined lumbar and sacral plexus blocks as methods of pain relief after hip fracture surgery. Participants will receive general anesthesia and then one of the two nerve block techniques using 40 ml of 0.25% bupivacaine. The lumbar and sacral plexus blocks aim to block nerves supplying the hip, while the circum-psoas block targets key lumbar plexus branches. The comparison evaluates which approach provides better sensory block and postoperative pain relief. Participants will be monitored for pain levels using the Visual Analogue Scale at several time points up to 24 hours after surgery. Sensory block levels will be assessed at 2 hours postoperatively, and the total dose of additional pain medication needed in the first 24 hours will be recorded. The study uses randomized, double-blind methods to compare these techniques in patients aged 60 and older undergoing hip fracture surgery. The trial will help determine effective pain management strategies for this patient group.
CONDITIONS
Brief Title
Circum-Psoas Blocks Versus Combined Lumbar and Sacral Plexus Blocks in Hip Fracture Surgery
Who Can Participate
Age: 60Years +
All Genders
Eligibility Criteria
You may qualify if you...
- Patient acceptance
- Body mass index (BMI) of 30 kg/m2 or less
- American Society of Anesthesiologists (ASA) physical status I to III
- First unilateral surgery for hip fracture including femoral neck, intertrochanteric, or subtrochanteric fracture
- Planned hip fracture surgery within 24 to 72 hours under general anesthesia
You will not qualify if you...
- Multiple trauma, multiple fractures, or pathological fractures
- Prosthetic fracture or use of bone-cement fixation during surgery
- Scheduled for bilateral hip fracture surgery
- Pre-existing neurological deficit in the lower extremity
- Contraindications to peripheral nerve block such as infection at needle site, blood clotting problems, or allergy to local anesthetics
- History of chronic pain requiring analgesics
- History of cognitive dysfunction or mental illness
AI-Screening
AI-Powered Screening
Complete this quick 3-step screening to check your eligibility
1
2
3
Your Study Journey
Screening
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Treatment
Duration - Up to 72 hours or until surgery completion
Participants undergo hip fracture surgery under general anesthesia and receive either combined lumbar and sacral plexus blocks or circum-psoas blocks for postoperative pain relief.
1 surgical and anesthesia visit
Post-operative Follow-up
Duration - 24 hours
Participants are monitored for postoperative pain and sensory block levels, with assessments occurring at multiple time points within the first 24 hours after surgery.
Visits at 30 minutes, 2, 4, 6, 12, and 24 hours postoperatively
Trial Site Locations
Total: 1 location
1
Shereen E Abd Ellatif
Zagazig, Alsharqia, Egypt, 4115
Actively Recruiting
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Research Team
S
Shereen E Abd Ellatif, MD
How is the study designed?
Study Type
INTERVENTIONAL
Masking
DOUBLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
PREVENTION
Number of Arms
3
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Published Research Related To This Trial
The suprasacral parallel shift vs lumbar plexus blockade with ultrasound guidance in healthy volunteers--a randomised controlled trial.
T F Bendtsen, E M Pedersen, S Haroutounian...
https://pubmed.ncbi.nlm.nih.gov/24974961Combined Lumbar-Sacral Plexus Block in High Surgical Risk Geriatric Patients undergoing Early Hip Fracture Surgery.
S Petchara, S Paphon, A Vanlapa...
https://pubmed.ncbi.nlm.nih.gov/28611906Evaluation of Sensory Loss Obtained by Circum-Psoas Blocks in Patients Undergoing Total Hip Replacement: A Descriptive Pilot Study.
Huili Li, Rong Shi, Peiqi Shao...
https://pubmed.ncbi.nlm.nih.gov/35378731