ABSTRACT
Healthcare professionals will be aware of the need to improve treatment of hip fractures, with the ultimate goal of returning the individual to pre-injury health. Patients with hip fractures awaiting surgery can experience severe pain that may be difficult to relieve with traditional analgesics. Physical assessment and essential nursing care require moving the patient, which further increases pain. Nerve blocks have been administered as a form of post-operative pain relief in a variety of surgical procedures, and there is growing interest in the use of femoral nerve blocks in the pre-operative period for patients with hip fractures. This article looks at the prevalence of hip fractures and associated problems. It highlights the importance of effective management of pain and explores the use of local anaesthetics for pain relief.
Subject(s)
Femoral Nerve , Hip Fractures/surgery , Nerve Block , Aged , Analgesics/pharmacology , Education, Nursing, Continuing , Hip Fractures/complications , Humans , Pain/drug therapy , Pain/etiologyABSTRACT
We undertook a randomised, controlled trial to compare the analgesic efficacy and opioid sparing effect of nerve stimulator-guided femoral nerve block with fascia iliaca compartment block in patients awaiting surgery for fractured neck of femur. Ten-centimetre visual analogue pain scores were measured before and 2 h after the block and opioid consumption was recorded in the 12-h period after the block. One hundred and ten patients were randomly assigned. Femoral nerve block provided superior pre-operative analgesia for fractured neck of femur compared with fascia iliaca compartment block. The difference in the mean reduction of pain score after the block was 0.9 (95% CI 0-1.8); p = 0.047. Patients receiving a femoral nerve block required less morphine after the block than those receiving fascia iliaca compartment block (p = 0.041).
Subject(s)
Femoral Neck Fractures/surgery , Nerve Block/methods , Pain/drug therapy , Preoperative Care/methods , Aged , Aged, 80 and over , Analgesics, Opioid/administration & dosage , Anesthetics, Local , Bupivacaine/analogs & derivatives , Electric Stimulation/methods , Fascia , Female , Femoral Nerve , Humans , Levobupivacaine , Male , Middle Aged , Pain Management/methods , Pain Measurement/methodsABSTRACT
The objectives of this study were to assess patient satisfaction with the current services provided for back pain, and to increase the level of understanding from the patients' perspective on beliefs about their back pain and how it affects their daily life. The study was conducted in two parts combining both quantitative and qualitative methodology. The main findings in the study revealed a high level of satisfaction with the services provided by the physiotherapy department and mixed levels of satisfaction with the GP. The GP was seen to be an expert yet failed to exhibit up-to-date knowledge about the causes and treatments for back pain. The issue of locus of control was a dominant theme throughout the study and those with stronger internal beliefs had a more positive outlook. The study revealed gaps in the current service provided, and the need for a more easily accessed service was desired.
