Implementing Regional Nerve Blocks in Hip Fracture Programs: A Review of Regional Nerve Blocks, Protocols in the Literature, and the Current Protocol at The Queen's Medical Center in Honolulu, HI

Hawaii J Health Soc Welf. 2019 Nov;78(11 Suppl 2):11-15.

Abstract

Hip fractures are a common cause of acute pain in elderly patients. However, pain may be undertreated due medical comorbidities. Strong evidence supports the use of regional nerve blocks to reduce preoperative pain after hip fracture. Despite recommendations for their use, regional nerve blocks may not be in widespread practice in the United States. To help promote the addition of regional nerve blocks into hip fracture protocols, this paper will provide an overview of two commonly used regional nerve blocks for hip fracture (fascia iliaca compartment block and femoral nerve block), review the regional nerve block protocols presented in 12 studies, and present the detailed protocol currently in use at The Queen's Medical Center in Honolulu, HI.

Keywords: Continuous Block; Fascia Iliaca Compartment Block; Femoral Nerve Block; Hip fracture; Opioid Sparing; Regional Anesthesia.

Publication types

  • Review

MeSH terms

  • Clinical Protocols*
  • Hawaii
  • Hip Fractures / surgery*
  • Humans
  • Nerve Block*
  • Pain Management*
  • Pain, Postoperative / prevention & control*