title: Ultrasound-guided fascia iliaca compartment block for hip fractures in the emergency department.
abstract: BACKGROUND
  Hip fracture (HFx) is a painful injury that is commonly seen in the emergency department (ED). Patients who experience pain from HFx are often treated with intravenous opiates, which may cause deleterious side effects, particularly in elderly patients. An alternative to systemic opioid analgesia involves peripheral nerve blockade. This approach may be ideally suited for the ED environment, where one injection could control pain for many hours.
  
  
  OBJECTIVE
  We hypothesized that an ultrasound-guided fascia iliaca compartment block (UFIB) would provide analgesia for patients presenting to the ED with pain from HFx and that this procedure could be performed safely by emergency physicians (EP) after a brief training.
  
  
  METHODS
  In this prospective, observational, feasibility study, a convenience sample of 20 cognitively intact patients with isolated HFx had a UFIB performed. Numerical pain scores, vital signs, and side effects were recorded before and after administration of the UFIB at pre-determined time points for 8h.
  
  
  RESULTS
  All patients reported decreased pain after the nerve block, with a 76% reduction in mean pain score at 120 min. There were no procedural complications.
  
  
  CONCLUSIONS
  In this small group of ED patients, UFIB provided excellent analgesia without complications and may be a useful adjunct to systemic pain control for HFx.
authors.affiliation: Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, New York 11209, USA.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Haines
authors.forename: Eitan
authors.initials: E
authors.lastname: Dickman
authors.forename: Sergey
authors.initials: S
authors.lastname: Ayvazyan
authors.forename: Michelle
authors.initials: M
authors.lastname: Pearl
authors.forename: Stanley
authors.initials: S
authors.lastname: Wu
authors.forename: David
authors.initials: D
authors.lastname: Rosenblum
authors.forename: Antonios
authors.initials: A
authors.lastname: Likourezos
mesh_terms: D000779:Anesthetics, Local / Q000008:administration & dosage; D002045:Bupivacaine / Q000008:administration & dosage; D004636:Emergency Service, Hospital; D005205:Fascia / Q000294:innervation; D005240:Feasibility Studies; D006620:Hip Fractures / Q000150:complications*; D006801:Humans; D007085:Ilium / Q000294:innervation; D009407:Nerve Block / Q000009:adverse effects; D010146:Pain / Q000209:etiology; D059408:Pain Management / Q000009:adverse effects; D011446:Prospective Studies; D013997:Time Factors; D018084:Ultrasonography, Interventional
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine