Hip Fracture Clinical Trial
Official title:
Analgesic Duration af a Preoperative Single-shot Femoral Nerve Block With Bupivacaine and Adjuvant Dexamethasone in Patients With Hip Fracture
Prolongation of the analgesic effect of a femoral nerve block from the present 15 hours to
24 hours in patients with hip fracture would have a major impact in order to provide better
preoperative analgesia for this group.
In other trials concerning other nerves then the femoral nerve the addition of Dexamethasone
to the local anesthetics doubled the analgesic duration. No studies has investigated the
effect of the addition of Dexamethasone to the femoral nerve block in patients with hip
fracture.
The aim of our study is to investigate if more patients with hip fracture experience lasting
preoperative analgesia until the time of operation or 20 hours after a femoral nerve block
with the addition of Dexamethasone compared to the same nerve block done without
Dexamethasone.
Patients with hip fractures are most often old, have multiple comorbidities and suffer
severe pain.
Femoral nerve block as a means of preoperative analgesia for these patients has proven
effective in multiple trials for the majority of the patients. Still some issues remains to
be investigated in order to optimize the preoperative analgesia for this group.
One of the issues that reduces the feasibility of the femoral nerve block is the relatively
shorter analgesic duration of the nerve block compared to the often longer time from the
hospital admission to the actual operation. From the literature and our own experience the
mean analgesic duration of a femoral nerve block approximates 15 hours.
Many studies have shown a prolonged analgesic duration of different nerve blocks when
Dexamethasone was added to the local anesthetics. Some studies show a 100 percent increase
in duration.
To our knowledge no studies have been published regarding prolongation of the analgesic
effect of the femoral nerve block with Dexamethasone, and also none regarding the group of
patients with hip fracture.
The clinical impact of a femoral nerve block with an analgesic duration of 20 hours compared
to the present 15 hours would be less patients waking up in wards during the night time with
pain and a terminated femoral nerve block.
The purpose of this study is to investigate if more patients with hip fracture experience a
lasting preoperative analgesic duration of at least 20 hours or until the time of operation
after a femoral nerve block with Bupivacaine with adrenaline and the addition of
Dexamethasone compared to the same nerve block done with only Bupivacaine with adrenaline.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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