50th Annual Regional Anesthesiology and Acute Pain Medicine Meeting

Resolution of Emergency Department Nerve Blocks for Hip Fractures Prior to Surgery: A Retrospective Analysis

Patients who sustain hip fractures are often frail and are at high risk for opioid related adverse events

Early access to ultrasound guided nerve blocks (UGNB) is associated with decreased opioid exposure

Limitations in operating room capacity and need for preoperative optimization may lead to prolonged waiting times

The expanding use of UGNB in the emergency department (ED) is effective for short term outcomes, however, few reports of long term analgesia

It is unknown how many patients’ blocks resolve prior to surgery and if there is any benefit from an acute pain consult prior to surgery

Goal: examine pain trajectories in hip fracture patients who receive UGND in the ED

Primary outcome: opioid consumption before nerve block, during nerve block procedure, and after nerve block leading up to surgical fixation

In alignment with previous studies, opioid requirements fell after patients received nerve blocks in the ED

After 36 hours, opioid requirements returned to pre-block levels

Patients may benefit from acute pain consult prior to surgery for additional block or nerve block catheters

Most patients went to surgery within 36 hours of hospital admission

Based on average opioids administered ten percent of patients showed block resolution prior to surgery

Limitations: retrospective study, data from two hospitals, selection bias for patients who received nerve blocks

Further collaborative work with anesthesiology, acute pain, orthopedic surgery, and emergency medicine physicians on these subjects is imperative to optimize care for this vulnerable population

50th Annual Regional Anesthesiology and Acute Pain Medicine Meeting

RESOLUTION OF EMERGENCY DEPARTMENT NERVE BLOCKS FOR HIP FRACTURES PRIOR TO SURGERY: A RETROSPECTIVE ANALYSIS.

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