Abstract
BACKGROUND: Femur fractures are one of the most serious injuries that occur in the older population and are associated with severe pain and increased mortality. The primary objective of this study was to find if there was a significant difference in pain scores in patients treated with femoral nerve blocks (FNB) compared with patients treated with the standard analgesia protocol. The secondary objective was to find if there was a significant difference in morbidity between the two groups. AIM: To evaluate the effectiveness of ultrasound (US)-guided FNB in managing preoperative pain and reducing morbidity in patients with neck femur fractures compared to the standard analgesia protocol. The study seeks to determine whether FNB offers superior outcomes in terms of pain control, rehospitalization rates, and mortality. METHODS: This retrospective cohort study included 1577 patients suffering from neck femur fractures. 387 patients were treated with a FNB for pain management upon arrival at the emergency department, the rest were treated with standard analgesia. Pain was assessed from electronic medical records using the visual analogue scale (VAS) pre surgery, 12- and 24-hour post-surgery. To determine morbidity and mortality during hospitalizations and 6 months after, it was collected from electronic medical records. RESULTS: In a cohort of 1577 patients, those receiving US-guided FNB had significantly lower preoperative VAS pain scores (1.46 ± 2.49 vs 1.82 ± 2.59, P = 0.001), reduced rehospitalization rates (0.99 ± 1.96 vs 1.46 ± 2.34, P < 0.001), and lower mortality (16% vs 32%, P < 0.001) compared to standard analgesia. CONCLUSION: US guided FNB is more effective for pain management compared with standard analgesia. This method was also found to significantly reduce the risk of morbidity in those patients.