Peripheral Nerve Blocks in Elderly Patients With Hip Fracture

Study Overview
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Brief Summary
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As the population ages, the frequency of surgery is increasing proportionally, bringing with it the challenge of managing older patients with frequent comorbid diseases and an increased risk of complications. Poor postoperative quality of recovery may result in patient and family suffering, a prolonged hospital stay, and a greater demand on health care resources.The purpose of this study was to evaluate the ultrasound guided percutaneous femoral nerve+lateral cutaneous nerve versus lumbar plexus+sacral plexus nerve block composite laryngeal mask anesthesia in elderly hip fracture surgery, the application of assessing their impact on the postoperative recovery quality.

Detailed Description
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In this study, patients who were more than 65 years old with hip fracture were randomized to peripheral nerve blocks 1(PNBs1)- femoral nerve+lateral cutaneous nerve-with laryngeal mask anesthesia, or peripheral nerve blocks 2(PNBs2) - lumbar plexus and sciatic - with laryngeal mask anesthesia. Blocks were performed using ultrasound and 0.5% ropivacaine. All patients received postoperative multimodal analgesia. Postoperative recovery was assessed at 15 minutes, 40 minutes,- 1 day, 3 days, and 7 days after surgery, with the Postoperative Quality of Recovery Scale, in physiological, nociceptive, emotive, modified activities of daily living, modified cognitive, and overall patient perspective domains.

Official Title
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A Randomized Controlled Trial of Comparing Two Methods of Nerve Block in Combination With Laryngeal Mask Anesthesia Effect for Hip Fracture on Post-operative Quality of Recovery in Elderly Patients

Conditions
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Hip Fracture

Intervention / Treatment
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* Procedure: Femoral nerve and the lateral cutaneous nerve block
* Procedure: Lumbar plexus and sacral plexus nerve block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ASA grade I   III level; The BMI <30; The Mini - getting the state examination MMSE > 23; The operation type:open reduction and internal fixation or bipolar head replace. Exclusion Criteria: Serious systemic diseases such as respiratory dysfunction, cardiac insufficiency, and renal insufficiency; Has a history of cognitive function disorder or mental illness; Has a history of cerebral infarction and leave sequela; The blood coagulation dysfunction; The hearing or visual impairment; Unable to complete assessment; Operation time more than 90 minutes; The bleeding is greater than 1000 ml.

Ages Eligible for Study
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Minimum Age: 65 Years
Maximum Age: 85 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: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: PNBs1<br>Femoral nerve and the lateral cutaneous nerve block combined with general anesthesia | Procedure: Femoral nerve and the lateral cutaneous nerve block<br>* Femoral nerve block was performed using 0.5% ropivacaine (15ml) under ultrasound guide;the lateral cutaneous nerve block was performed using 0.5% ropivacaine (5ml) under ultrasound guide<br>|
| Other: PNBs2<br>Lumbar plexus and sacral plexus nerve block combined with general anesthesia | Procedure: Lumbar plexus and sacral plexus nerve block<br>* Lumbar plexus block was performed using 0.5% ropivacaine (25ml) under ultrasound guide; sacral plexus nerve block was performed using 0.5% ropivacaine (15ml) under ultrasound guide<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| postoperative quality of recovery |  | 3 days after operative | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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nerve block, general anesthesia, hip fracture, recovery