Fascia iliaca compartment block as a preoperative analgesic in elderly patients with hip fractures – effects on cognition
Abstract Background Impaired cognition is a major risk factor for perioperative delirium. It is essential to provide good pain control in patients with hip fractures and especially important in patients with severely impaired cognitive status, as they receive less pain medication, have poorer mobili...
Main Authors: | , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2019-09-01
|
Series: | BMC Geriatrics |
Subjects: | |
Online Access: | http://link.springer.com/article/10.1186/s12877-019-1266-0 |
id |
doaj-cffa6c439f9a469ba7d1c3d214453702 |
---|---|
record_format |
Article |
spelling |
doaj-cffa6c439f9a469ba7d1c3d2144537022020-11-25T03:50:45ZengBMCBMC Geriatrics1471-23182019-09-011911810.1186/s12877-019-1266-0Fascia iliaca compartment block as a preoperative analgesic in elderly patients with hip fractures – effects on cognitionPär Wennberg0Margareta Möller1Johan Herlitz2Elisabeth Kenne Sarenmalm3Research and Development Centre, Skaraborg HospitalUniversity Health Care Research Center, Region Örebro and School of Health and Medical Sciences, Örebro UniversityPrehospen-Centre of Prehospital Research; Faculty of Caring Science, Work-Life and Social Welfare, University of BoråsResearch and Development Centre, Skaraborg HospitalAbstract Background Impaired cognition is a major risk factor for perioperative delirium. It is essential to provide good pain control in patients with hip fractures and especially important in patients with severely impaired cognitive status, as they receive less pain medication, have poorer mobility, poorer quality of life and higher mortality than patients with intact cognition. The purpose of this study was to examine the association between preoperative pain management with nerve blocks and cognitive status in patients with hip fractures during the perioperative period. Methods One hundred and twenty-seven patients with hip fractures participating in a double-blind, randomised, controlled trial were included in this study. At hospital admission, a low-dose fascia iliaca compartment block (FICB) was administered as a supplement to regular analgesia. Cognitive status was registered on arrival at hospital before FICB and on the first postoperative day using the Short Portable Mental Status Questionnaire. Results Changes in cognitive status from arrival at hospital to the first postoperative day showed a positive, albeit not significant, trend in favour of the intervention group. The results also showed that patients with no or a moderate cognitive impairment received 50% more prehospital pain medication than patients with a severe cognitive impairment. FICB was well tolerated in patients with hip fractures. Conclusion Fascia iliaca compartment block given to patients with hip fractures did not affect cognitive status in this study. Patients with a cognitive impairment may receive inadequate pain relief after hip fracture and this discrimination needs to be addressed in further studies. Trial registration EudraCT number 2008–004303-59 date of registration: 2008-10-24.http://link.springer.com/article/10.1186/s12877-019-1266-0Hip fracturesCognitive impairmentCognitive statusPainNerve blockPain management |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Pär Wennberg Margareta Möller Johan Herlitz Elisabeth Kenne Sarenmalm |
spellingShingle |
Pär Wennberg Margareta Möller Johan Herlitz Elisabeth Kenne Sarenmalm Fascia iliaca compartment block as a preoperative analgesic in elderly patients with hip fractures – effects on cognition BMC Geriatrics Hip fractures Cognitive impairment Cognitive status Pain Nerve block Pain management |
author_facet |
Pär Wennberg Margareta Möller Johan Herlitz Elisabeth Kenne Sarenmalm |
author_sort |
Pär Wennberg |
title |
Fascia iliaca compartment block as a preoperative analgesic in elderly patients with hip fractures – effects on cognition |
title_short |
Fascia iliaca compartment block as a preoperative analgesic in elderly patients with hip fractures – effects on cognition |
title_full |
Fascia iliaca compartment block as a preoperative analgesic in elderly patients with hip fractures – effects on cognition |
title_fullStr |
Fascia iliaca compartment block as a preoperative analgesic in elderly patients with hip fractures – effects on cognition |
title_full_unstemmed |
Fascia iliaca compartment block as a preoperative analgesic in elderly patients with hip fractures – effects on cognition |
title_sort |
fascia iliaca compartment block as a preoperative analgesic in elderly patients with hip fractures – effects on cognition |
publisher |
BMC |
series |
BMC Geriatrics |
issn |
1471-2318 |
publishDate |
2019-09-01 |
description |
Abstract Background Impaired cognition is a major risk factor for perioperative delirium. It is essential to provide good pain control in patients with hip fractures and especially important in patients with severely impaired cognitive status, as they receive less pain medication, have poorer mobility, poorer quality of life and higher mortality than patients with intact cognition. The purpose of this study was to examine the association between preoperative pain management with nerve blocks and cognitive status in patients with hip fractures during the perioperative period. Methods One hundred and twenty-seven patients with hip fractures participating in a double-blind, randomised, controlled trial were included in this study. At hospital admission, a low-dose fascia iliaca compartment block (FICB) was administered as a supplement to regular analgesia. Cognitive status was registered on arrival at hospital before FICB and on the first postoperative day using the Short Portable Mental Status Questionnaire. Results Changes in cognitive status from arrival at hospital to the first postoperative day showed a positive, albeit not significant, trend in favour of the intervention group. The results also showed that patients with no or a moderate cognitive impairment received 50% more prehospital pain medication than patients with a severe cognitive impairment. FICB was well tolerated in patients with hip fractures. Conclusion Fascia iliaca compartment block given to patients with hip fractures did not affect cognitive status in this study. Patients with a cognitive impairment may receive inadequate pain relief after hip fracture and this discrimination needs to be addressed in further studies. Trial registration EudraCT number 2008–004303-59 date of registration: 2008-10-24. |
topic |
Hip fractures Cognitive impairment Cognitive status Pain Nerve block Pain management |
url |
http://link.springer.com/article/10.1186/s12877-019-1266-0 |
work_keys_str_mv |
AT parwennberg fasciailiacacompartmentblockasapreoperativeanalgesicinelderlypatientswithhipfractureseffectsoncognition AT margaretamoller fasciailiacacompartmentblockasapreoperativeanalgesicinelderlypatientswithhipfractureseffectsoncognition AT johanherlitz fasciailiacacompartmentblockasapreoperativeanalgesicinelderlypatientswithhipfractureseffectsoncognition AT elisabethkennesarenmalm fasciailiacacompartmentblockasapreoperativeanalgesicinelderlypatientswithhipfractureseffectsoncognition |
_version_ |
1724490733127204864 |