The use of a regional nerve block may provide noticeable pain relief, reduce the time to first mobilization, and decrease the risk for pneumonia in patients with hip fractures, according to a systematic review published in the Annals of Emergency Medicine.
Investigators obtained data from randomized-controlled trials comparing the use of a regional nerve block with the absence of a nerve block in patients with hip fractures. A total of 1760 patients from 31 randomized trials were included in the review.
Patients receiving a regional nerve block experienced a mean reduction in pain on movement of 1.41 unit 30 minutes after the intervention. This value is similar to a 3.4 unit-reduction on a 10-point pain rating scale. In addition, patients receiving a regional nerve block had a lower incidence of pneumonia compared with untreated study participants (10.9% and 26.9%, respectively). Although the investigators reported an association between regional nerve block and decreased opioid consumption and with increased patient satisfaction, no numerical data were provided.
Since this study was a review of previously published research, there is a potential variation in therapy characteristics among studies. These variations include the types of nerve blocks conducted as well as therapy techniques. As such, future clinical trials may be necessary to establish an association between a specific type of nerve block and improvements in fracture-related pain.
Despite the inherent limitations of this study, the investigators believe that the use of a nerve block “can be a valuable intervention for patients awaiting admission or operative management” of pain associated with hip fracture.
Gottlieb M, Chien N, Seagraves T, et al. How effective is a regional nerve block for treating pain associated with hip fractures? Ann Emerg Med [published online October 26, 2017]. doi:10.1016/j.annemergmed.2017.09.032