SiFi vs FNB Local Anesthesia for Hip Fracture Surgeries

Surgery Clinical Trial

Official title:

Femoral Nerve Blockade (FNB) vs Suprainguinal Fascia Iliaca Block (SiFi) for Hip Fracture Surgery

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT06296758
• Other study ID #: SiFi_HIP FRACTURE
• Status: Not yet recruiting
• Phase: N/A
• Start date: June 10, 2024
• Est. completion date: May 1, 2026

Study information

• Verified date: June 2024
• Source: University of Alberta
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The goal of this clinical trial is to compare two commonly used local/regional anesthesia techniques in adults patients undergoing hip fracture surgery. The main question[s] it aims to answer are: • the impact of both interventions on patient level of pain. • impact on postoperative analgesics administered Participants will be randomly assigned to one of two local/regional anesthesia techniques, either femoral nerve block (FNB) or suprainguinal fascia iliaca block (SiFi). Both techniques are the usual practice at the hospital, and we are NOT aiming to experiment on new anesthesia technique in this study.

Description:

Hip fracture in the elderly is an increasingly common problem worldwide. Nearly all patients with a hip fracture undergo surgery. Patients with hip fractures often have significant pain, particularly with movement, and surgical fixation is associated with significant pain.

The treatment of pain with the use of a multimodal analgesic regimen is a major priority for elderly patients with hip fractures. These patients are often frail and have multiple medical comorbidities. Hence the use of non-steroidal anti-inflammatories drugs and systemic opioids may be contraindicated or complicated by adverse effects. Regional anesthesia techniques including femoral nerve blocks (FNB) and fascia iliaca compartment blocks (FICB) are frequently utilized as part of multimodal analgesia due to their relative lack of side-effects. Femoral nerve blockade and suprainguinal fascia iliaca (SiFi) blockade have been described for this indication. Several studies have investigated the analgesic efficacy of the SiFi block after total hip arthroplasty. However, randomized controlled trials on the analgesic efficacy of the SiFi block for pain after hip fracture surgery are not plentiful and subject to methodological concerns.

Objectives:

The primary objective is to test the hypothesis that in patients undergoing hip fracture surgery, suprainguinal fascia iliaca block is associated with improved pain scores and a reduction in opioid utilization when compared with femoral nerve block. Secondary objectives will be to compare time to mobilization, time to readiness for discharge and complications associated with both nerve block techniques.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 106
• Est. completion date: May 1, 2026
• Est. primary completion date: March 10, 2026
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Age 18 or greater

• Having hip fracture surgery at the University of Alberta Hospital

• Suitable for multimodal analgesia including a peripheral nerve block

Exclusion Criteria:

• Contraindication to a nerve block technique

• Refuses consent for a nerve block technique

Related Conditions & MeSH terms

• Anesthesia, Local
• Fractures, Bone
• Hip Fractures
• Surgery

Intervention

Procedure:
• Regional anesthesia
ultrasound-guided suprainguinal fascia iliaca block with 40ml of ropivacaine local or ultrasound-guided femoral nerve block with 20ml of ropivacaine local anesthetic

Locations

Country	Name	City	State
Canada	University of Alberta Hospital	Edmonton	Alberta

Sponsors (1)

Lead Sponsor	Collaborator
University of Alberta

Country where clinical trial is conducted

Canada, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Postoperative pain	Postoperative numerical pain rating scale (NRS) pain scores	48 hours
Primary	Postoperative analgesics administered	Postoperative opioid utilization	48 hours
Secondary	Mobilization	Time to first mobilization	48 hours
Secondary	Time to readiness for discharge	Time to 'ready for discharge'	48 hours
Secondary	Complications	Complications associated with both block techniques	48 hours