Evaluating the Addition of Regional Analgesia to Reduce Postoperative Delirium in Patients Having Hip Fracture Surgery.

Study Overview
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Brief Summary
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Post operative delirium is common after hip fracture surgery and is associated with increased length of hospital stay, delayed recovery and increased mortality. Postoperative delirium can also decrease a patient's quality of life and increase treatment costs. Anesthesia and pain relief (analgesia) treatments may also influence the incidence of delirium, but more research is needed into which techniques are effective in improving patient outcomes, care and decreasing costs. This pilot study compares the addition of regional analgesia as part of general anesthesia to determine the incidence of delirium following hip surgery. This is a collaborative study involving anesthesia, orthopedic surgery and geriatrics in the improvement of patient care.

Official Title
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The Use of Post-operative Regional Analgesia Rather Than Systemic Analgesia to Decrease the Incidence of Post-operative Delirium After Acute Hip Fracture Surgery? A Prospective Randomized-controlled Double-blinded Pilot Study.

Conditions
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Delirium, Hip Fracture

Intervention / Treatment
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* Procedure: Femoral Nerve Block


Participation Criteria
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Eligibility Criteria
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Inclusion criteria (must meet all 3): Greater than or equal to 65 years Have a hip fracture requiring surgery Written informed consent for participation of study prior to surgery. Exclusion criteria: Contraindication to peripheral nerve block or local anaesthetics Unable to do delirium or cognitive testing due to language, vision or hearing impairment Unable to communicate with research staff due to language barriers History of chronic opioid use (longer than 1 month) Contraindication to general anesthesia

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: General Anesthesia with nerve block<br>Femoral Nerve Block | Procedure: Femoral Nerve Block<br>* Use of femoral nerve block as part of general anesthesia<br>* Other names: Regional Anesthesia;|
| No Intervention: General Anesthesia no nerve block<br>No femoral Nerve Block | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The incidence of post-operative delirium after hip fracture surgery | Identify the our local incidence of post operative delirium diagnosed with 3D-CAM (3 Minute Diagnostic Assessment for Confusion Assessment Method) | immeidately to 5 days post operatively | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Decreased recovery time after surgery | reduction in length of stay and recovery time | immediately - immediately - 90 days | 
| Decrease post-operative opioid consumption | reduction in the requirement for systemic/opiod analgesia | immediately - immediately - 90 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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analgesia, regional analgesia, femoral nerve block, older persons, frail