Combined Plexus Block for Hip Fracture Surgery.

Hip Fractures Clinical Trial

Official title:

Is the Combined Plexus Block a Real Alternative for Hip Fracture Surgery in the Elderly? A Comparison With General Anesthesia and Continuous Spinal Anesthesia Using a Propensity Score in a Retrospective Cohort Study.

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03356704
• Other study ID #: RECHMPL17_0229
• Status: Completed
• Start date: August 31, 2016
• Est. completion date: October 26, 2017

Study information

• Verified date: October 2017
• Source: University Hospital, Montpellier
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

Hip fracture surgery requires high risk anesthetic procedure for elderly patients (1). General anesthesia, continuous spinal anesthesia and peripheral nerve blocks are three anesthetic techniques possible. Continuous spinal anesthesia has proven its efficacity to provide an intraoperative haemodynamic stability wich guarantees good patients outcomes (2), in comparison with general anesthesia but there is poor evidence in the literature concerning the use of peripheral nerve blocks.

The primary objective of this study was to compare intraoperative haemodynamic stability provides by peripheral nerve block versus general anesthesia and continuous spinal anesthesia.

Secondary outcomes included : use of vasoactive drugs, opioids consumption, lengh of stay and inhospital mortality.

Description:

After receiving the ethic approval from the "CERAR", the investigators retrospectively identified all patients who underwent hip fracture surgery from January 1 2015, to December 31, 2016 in the CHU of Montpellier. The exclusion criteria were: multiple trauma victims, two hip fractures in the same patient and single shot spinal anesthesia. In our institution the investigators used to perform three types of anesthesia: general anesthesia (GA), continuous spinal anesthesia (CSA) and combined plexus blocks (CPB). The investigators therefore made three groups GA, CSA and CPB and used a propensity score to make these groups comparable. The matching criteria were age, arterial hypertension, ASA status, Frailty score, chronic cardiac failure and type of surgery.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 593
• Est. completion date: October 26, 2017
• Est. primary completion date: February 1, 2017
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion criteria:

• Adult

• Hip fracture surgery

Exclusion criteria:

• Multiple trauma victims

• Second hip fracture in same patient

• Single shot spinal anesthesia

Related Conditions & MeSH terms

• Fractures, Bone
• Hip Fractures

Intervention

Other:
• no intervention
Observational study

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
University Hospital, Montpellier

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Intraoperative hypotension	Decrease of at least 30% of mean arterial pressure	1 day
Secondary	measure the total consumption of the vasopressive molecules	measure the total consumption of the vasopressive molecules (necessary when the voltage drops by more than 30% compared to the average reference voltage) : Use of vasoactive drugs	1 day
Secondary	Length of stay	Length of stay	1 day
Secondary	compare the use of emergency antalgics	compare the use of emergency antalgics : opioids consumption	1 day
Secondary	Inhospital mortality	Inhospital mortality	1 day