Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Continuous Fascia Iliaca Block for Acute Hip Fractures: a Randomized Controlled Pilot Study
Brief Summary: Hip fractures are a major cause of morbidity and mortality in the elderly with over 30,000 hip fractures occuring in Canada annually and over 1300 in Saskatchewan. The estimated cost associated with hip fractures is over $600 million nationally and 28 million dollars in Saskatchewan. Hip fractures cause a great deal of pain and immobility and are mainly treated with surgical fixation. In the perioperative period, hip fracture patients are treated mainly with opioids and other adjuncts such as NSAIDS and acetaminophen. Opioid consumption in the elderly population can predispose to delirium and respiratory complications such as atelectasis, respiratory depression, and pneumonia.

Fascia iliaca blocks have been shown to be an effective mode of analgesia for patients with hip fractures, but are underutilized for varying reasons including culture of practice, expertise with performing the block, and having a dedicated service to do so.

This study aims to compare the efficacy of fascia iliaca blocks to standard treatment (opioids) in the management of pain in hip fracture patients with a particular focus on outcomes such as the incidence of delirium, respiratory complications, and length of stay in hospital. Our idea is that if we can reduce the amount of opioids these patients receive then they will have improved pain control, fewer respiratory complications, earlier time to mobilizing, and shorter hospital stays. As far as we are aware this relation has not been well studied.


Options:
A: Arm Label: Compartment Block; Type: ACTIVE_COMPARATOR; Interventions: Drug: Ropivacaine, Drug: Epinephrine | Arm Label: Infiltration; Type: ACTIVE_COMPARATOR; Interventions: Drug: Ropivacaine, Drug: Epinephrine | Intervention Type: DRUG; Name: Ropivacaine; Assigned to Arm(s): Compartment Block, Infiltration | Intervention Type: DRUG; Name: Epinephrine; Assigned to Arm(s): Compartment Block, Infiltration
B: Arm Label: Placebo; Type: PLACEBO_COMPARATOR; Interventions: Drug: Placebo, Device: Ultrasound guided fascia iliaca compartment block, Drug: Intrathecal medications (bupivacaine (15 mg) in conjunction with fentanyl 20 micrograms) | Arm Label: Bupivacaine; Type: ACTIVE_COMPARATOR; Interventions: Drug: Bupivacaine, Device: Ultrasound guided fascia iliaca compartment block, Drug: Intrathecal medications (bupivacaine (15 mg) in conjunction with fentanyl 20 micrograms) | Intervention Type: DRUG; Name: Placebo; Assigned to Arm(s): Placebo | Intervention Type: DRUG; Name: Bupivacaine; Assigned to Arm(s): Bupivacaine | Intervention Type: DEVICE; Name: Ultrasound guided fascia iliaca compartment block; Assigned to Arm(s): Bupivacaine, Placebo | Intervention Type: DRUG; Name: Intrathecal medications (bupivacaine (15 mg) in conjunction with fentanyl 20 micrograms); Assigned to Arm(s): Bupivacaine, Placebo
C: Arm Label: U/S Guided Regional Anesthesia; Type: EXPERIMENTAL; Interventions: Procedure: Fascia-Iliaca Block(FIB), Procedure: Femoral Nerve Block(FNB) | Arm Label: Current Local Standard Analgesia; Type: NO_INTERVENTION; Interventions: N/A | Intervention Type: PROCEDURE; Name: Fascia-Iliaca Block(FIB); Assigned to Arm(s): U/S Guided Regional Anesthesia | Intervention Type: PROCEDURE; Name: Femoral Nerve Block(FNB); Assigned to Arm(s): U/S Guided Regional Anesthesia
D: Arm Label: Standard Treatment; Type: NO_INTERVENTION; Interventions: N/A | Arm Label: Continuous fascia iliaca block; Type: EXPERIMENTAL; Interventions: Procedure: Continuous fascia iliaca block, Drug: Ropivacaine | Intervention Type: PROCEDURE; Name: Continuous fascia iliaca block; Assigned to Arm(s): Continuous fascia iliaca block | Intervention Type: DRUG; Name: Ropivacaine; Assigned to Arm(s): Continuous fascia iliaca block

Answer: D