Table E-5, Nerve blocks - Pain Management Interventions for Hip Fracture

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Abou-Setta AM, Beaupre LA, Jones CA, et al. Pain Management Interventions for Hip Fracture [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2011 May. (Comparative Effectiveness Reviews, No. 30.)

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Pain Management Interventions for Hip Fracture [Internet].

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Table E-5Nerve blocks

Study	Study characteristics	Interventions	Inclusion/Exclusion criteria
Antonopoulou 2006⁸⁸	Study design: RCT Study period: NR Type of hospital: General hospital Country: Greece Financial support: NR	Intervention #1: Classification: Femoral nerve block Intervention: Bolus: Levobupivacaine 0.25%; Maintanence: Levobupivacaine 0.12% Dosage: 18ml Intervals: Single administration; Continuous administration Intervention #2: Classification: Analgesia Intervention: Paracetamol; Pethidine Dosage: 500mg; NR Intervals: Every 8hrs; on demand	Main inclusion criteria: Pts with hip fracture Main exclusion criteria: NR
Chudinov 1999⁸⁹	Study design: RCT Study period: NR Type of hospital: General hospital Country: Israel Financial support: NR	Intervention #1: Classification: Psoas Compartment Block (continuous) Intervention: Bupivacaine 0.25% Dosage: Bolus: 2mg per kg; Maintainence: 2mg per kg Intervals: Single administration/Maintainence: every 12hrs Intervention #2: Classification: IM analgesia Intervention: Meperidine IM Dosage: 1mg per kg Intervals: On demand (max every 5hrs)	Main inclusion criteria: Pts with unilateral fractures of the neck of the femur Main exclusion criteria: Severe cardiac, pulmonary, renal, or liver dysfunction, systemic infection, decubitus ulcers, dementia, aspirin or anticoagulant treatment, or known hypersensitivity to local anesthetic agents
Coad 1991⁹⁰	Study design: RCT Study period: NR Type of hospital: General hospital Country: UK Financial support: NR	Intervention #1: Classification: 3-in-1 nerve block Intervention: Bupivacaine 0.5% Dosage: 15ml Intervals: Single administration Intervention #2: Classification: Lateral cutaneous Nerve Block Intervention: Bupivacaine 0.5% Dosage: 15ml Intervals: Single administration Intervention #3: Classification: Standard care Intervention: NR Dosage: NR Intervals: NR	Main inclusion criteria: Pts undergoing either pin-and-plate or compression-screw fixation of the femoral neck Main exclusion criteria: Pts who were receiving analgesic drugs, were suffering from dementia, or if regional anesthesia was thought to be indicated
Cuvillon 2007⁹¹	Study design: Randomized controlled trials Study period: 36404 to 37408 Type of hospital: University hospital Country: France Financial support: Fondation de l'avenir (Paris)	Intervention #1: Classification: 3-in-1 nerve block (NS) Intervention: Ropivacaine Dosage: Catheter attached to pump allowing continuous ropivacaine 0.2% at 10 mL/hr × 48 hr Intervals: Continuous Intervention #2: Classification: Analgesia Intervention: Paracetamol Dosage: 1st dose 2g then 2g Intervals: every 6 hours Intervention #3: Classification: Analgesia Intervention: Morphine Dosage: 2 mg q5min in post-op until VAS <30 then 0.1 mg/kg q4 hr; if VAS >30 dosage increased by 50% Intervals: NA	Main inclusion criteria: Pts ≥70 yrs; operation for traumatic fracture sup. femur under spinal anesthetic Main exclusion criteria: Patient refusal to participate; > 72 hr delay between fall and surgery; Pts < 70 yrs; weight < 40 kg; ASA score > 4; contraindications to locoregional analgesia; neuropathy; severe renal or hepatic insufficiency; noncooperative patients; mini mental score less than 15/30
de Visme 2000⁹²	Study design: RCT Study period: NR Type of hospital: University hospital Country: France Financial support: Financial support provided by institutional and/or departmental sources	Intervention #1: Classification: Combined lumbar/sacral plexus block (NS) Intervention: Lidocaine 1.33% Dosage: 45mL Intervals: Single administration Intervention #2: Classification: Spinal anesthesia (single) Intervention: Bupivacaine 0.5% Dosage: 3mL Intervals: Single administration	Main inclusion criteria: Pts > 65 yrs with proximal femoral fracture Main exclusion criteria: Pts with evidence of cognitive deficit (MMSE <5), contraindication to spinal anesthesia, or peripheral nerve block
Del Rosario 2008¹¹⁷	Study design: Retrospective cohort study Study period: Oct-04 to Oct-05 Type of hospital: General hospital Country: Spain Financial support: NR	Intervention #1: Classification: Femoral nerve block (NS)/IV analgesia Intervention: Bolus: Bupivacaine 0.25%; Maintainence: bupivaine 0.1%; PCA: Paracetamol IV/metamizol IV Dosage: 30ml/5ml/1g/2g Intervals: Single administration; Maintainence: every hr; Patient controlled bolus: every 6hrs/every 8hrs Intervention #2: Classification: IV analgesia Intervention: Paracetamol IV; metamizol IV Dosage: 1g; 2g Intervals: Every 6hrs; every 8hrs	Main inclusion criteria: Pts > 50 yrs who underwent hip fracture surgery with intradural anesthesia Main exclusion criteria: Pts who received general or epidural analgesia, presented failure of femoral analgesia, or had localized infection or coagulopathy
Eyrolle 1998⁹³	Study design: RCT Study period: NR Type of hospital: University hospital Country: France Financial support: NR	Intervention #1: Classification: Posterior lumbar plexus block Intervention: Lidocaine 2%/Bupivacaine 0.5% Dosage: NR Intervals: NR Intervention #2: Classification: Spinal anesthesia (single) Intervention: Bupivacaine 0.5% Dosage: NR Intervals: Single administration	Main inclusion criteria: Pts undergoing femoral neck osteosynthesis Main exclusion criteria: NR
Fletcher 2003⁹⁴	Study design: RCT Study period: Feb to Aug Type of hospital: General hospital Country: UK Financial support: NR	Intervention #1: Classification: 3-in-1 nerve block (NS) Intervention: Bupivacaine 0.5% Dosage: 20mL Intervals: Single administration Intervention #2: Classification: IV analgesia Intervention: Morphine IV Dosage: 5-10mg Intervals: On demand	Main inclusion criteria: Pts with all types of fractured neck of femur Main exclusion criteria: Confused, with a bleeding diathesis, taking warfarin, local or systemic infection, or previous hypersensitivity to local anesthetics
Foss 2005⁹⁵	Study design: RCT Study period: Jan-03 to Apr-04 Type of hospital: University hospital Country: Denmark Financial support: Financial support provided by governmental sources	Intervention #1: Classification: Epidural analgesia (continuous) Intervention: Bupivacaine 0.125%/morphine Dosage: 4ml of 50ug per ml per hr Intervals: Continuous infusion (four days) Intervention #2: Classification: Placebo Intervention: Saline Dosage: NA Intervals: Continuous inusion (four days)	Main inclusion criteria: ≥65 yrs living in own home, intact cognitive status, able to provide written informed consent, New Mobility Score of ≥3 (indicating independent indoor ambulation) Main exclusion criteria: Refused to participate, prefracture hospitalization, contraindications to epidural analgesia, regular prefracture opioid or glucocorticoid therapy, alcohol or substance abuse, morphine intolerance, and postoperative restrictions for ambulation
Foss 2007⁹⁶	Study design: Randomized controlled trials Study period: May-03 to Jan-06 Type of hospital: University hospital Country: Denmark Financial support: Imk Almene Fond	Intervention #1: Classification: Fascia iliaca compartment nerve block (CT) Intervention: 1.0% mepivacaine Dosage: 40 mL 1.0% mepivacaine with 1:200 000 epinephrine; 0.02 mL/kg placebo IM injection of 0.9% saline Intervals: Single dose Intervention #2: Classification: Analgesia Intervention: Morphine Dosage: 40 mL placebo FICB with 0.9% saline; 0.02 mL/kg 5.0 mg/mL morphine Intervals: Single dose	Main inclusion criteria: Clinical signs of hip fracture as assessed by the ED staff; intact cognitive status on admission; and the ability to provide written informed consent. Main exclusion criteria: Refusal to participate in the study; previous surgery in the affected hip; regular prefracture opioid or glucocorticoid therapy; alcohol or substance abuse; infection at the injection site; morphine intolerance; or any previous opioid administration for the acute pain and nonconfirmation of the hip fracture suspicion on x-ray
Gille 2006⁹⁷	Study design: Randomized controlled trials Study period: NR to NR Type of hospital: University hospital Country: Germany Financial support: No industry funding	Intervention #1: Classification: Femoral nerve block Intervention: Prilocaine 1%/ Ropivacaine 0.2% Dosage: 40ml/ 30ml Intervals: Single administration/ Continuous (every 6hrs) Intervention #2: Classification: Analgesia Intervention: Metamizol/ Tilidine; Ibuprofen Dosage: 1g / 100mg; 400mg Intervals: Single administration/ single administration; every 8hrs	Main inclusion criteria: Isolated hip fracture Main exclusion criteria: Open fracture or fracture associated with neurological injury; age<18 years; inability to swallow pills; contraindication for regional anesthesia or medications in trial; ongoing opiod analgesic therapy; multiple injuries; repeat intervention
Graham 2008⁹⁸	Study design: RCT Study period: Apr-00 to Oct-01 Type of hospital: General hospital Country: UK Financial support: NR	Intervention #1: Classification: 3-in-1 nerve block (NS) Intervention: Bupivacaine 0.5% Dosage: 30ml Intervals: Single administration Intervention #2: Classification: IV analgesia Intervention: Morphine IV Dosage: 0.1mg per kg Intervals: Single administration	Main inclusion criteria: Pts > 16 yrs presenting with clinical or radiological evidence of fractured hip Main exclusion criteria: Pts with suspected allergy or contraindication to either morphine or bupivacaine, or if they had an abbreviated mental test score <9
Haddad 1995⁹⁹	Study design: RCT Study period: NR Type of hospital: General hospital Country: UK Financial support: No external funding	Intervention #1: Classification: Femoral nerve block (CT) Intervention: Bupivacaine 0.25% Dosage: 0.3ml per kg Intervals: Single administration Intervention #2: Classification: Standard care Intervention: NR Dosage: NR Intervals: NR	Main inclusion criteria: Pts with extracapsular fractures of the femoral neck Main exclusion criteria: Pts who were unable to score their pain due to dementia
Henderson 2008¹⁰⁰	Study design: RCT Study period: NR Type of hospital: General hospital Country: US Financial support: NR	Intervention #1: Classification: Femoral nerve block/Opioids Intervention: Bupivacaine 0.5% Dosage: NR/NR Intervals: Continuous/On demand Intervention #2: Classification: Standard care Intervention: Opioids Dosage: NR Intervals: Intermittent	Main inclusion criteria: ≥55 yrs presenting to the ED with acute hip fractures Main exclusion criteria: NR
Hood 1991¹⁰¹	Study design: RCT Study period: NR Type of hospital: General hospital Country: UK Financial support: NR	Intervention #1: Classification: 3-in-1 nerve block Intervention: Prilocaine 0.75% Dosage: 43ml Intervals: Single administration Intervention #2: Classification: Standard care Intervention: NR Dosage: NR Intervals: NR	Main inclusion criteria: > 60 yrs with intertrochanteric fractures of neck of femur requiring surgical correction with compression screw or pin and plate devices Main exclusion criteria: Contraindication to a regional technique, allergy to local anesthetic agents, or systemic disease that indicated an alternative method of anesthesia
Kocum 2007¹¹⁸	Study design: Retrospective cohort study Study period: Sep-04 to Aug-05 Type of hospital: University hospital Country: Turkey Financial support: NR	Intervention #1: Classification: Lumbar plexus plus sciatic block (NS) Intervention: Ropivacaine 0.25% Dosage: 60ml Intervals: Single administration Intervention #2: Classification: Lumbar plexus plus sciatic block (NS) Intervention: Bupivacaine 0.25% Dosage: 60ml Intervals: Single administration	Main inclusion criteria: Pts, ASA III-IV, who underwent unilateral femur or hip surgery with lumbar plexus and sciatic nerve blockade Main exclusion criteria: Pts ASA I-II and those who received additional anesthesia modalities or who had other fractures
Mannion 2005¹⁰²	Study design: RCT Study period: NR Type of hospital: University hospital Country: Ireland Financial support: NR	Intervention #1: Classification: Psoas compartment block (NS) Intervention: Levobupivacaine 0.5%/Clonidine IV Dosage: 0.4mL per kg/1ug per kg Intervals: Single administration Intervention #2: Classification: Psoas compartment block (NS) Intervention: Levobupivacaine 0.5%/Clonidine (peripheral) Dosage: 0.4mL per kg/1ug per kg Intervals: Single administration Intervention #3: Classification: Psoas compartment block (NS) Intervention: Levobupivacaine 0.5% Dosage: 0.4mL per kg Intervals: Single administration	Main inclusion criteria: Pts scheduled for surgical repair of traumatic hip fractures Main exclusion criteria: Concurrent medication with adrenoceptor agonists, antagonists, or contraindications to regional anesthesia
Marhofer 1997¹⁰³	Study design: RCT Study period: NR Type of hospital: University hospital Country: Austria Financial support: NR	Intervention #1: Classification: 3-in-1 nerve block (US) Intervention: Bupivacaine 0.5% Dosage: 20ml Intervals: Single administration Intervention #2: Classification: 3-in-1 nerve block (NS) Intervention: Bupivacaine 0.5% Dosage: 20ml Intervals: Single administration	Main inclusion criteria: Pts undergoing hip surgery after trauma Main exclusion criteria: Pts who refused to participate or had contraindication to local anesthetics or puncture in the inguinal area, or unable to understand the study protocol
Marhofer 1998¹⁰⁴	Study design: RCT Study period: NR Type of hospital: University hospital Country: Austria Financial support: NR	Intervention #1: Classification: 3-in-1 nerve block (US) Intervention: Bupivacaine 0.5% Dosage: 20ml Intervals: Single administration Intervention #2: Classification: 3-in-1 nerve block (NS) Intervention: Bupivacaine 0.5% Dosage: 20ml Intervals: Single administration Intervention #3: Classification: 3-in-1 nerve block (NS) Intervention: Bupivacaine 0.5% Dosage: 30ml Intervals: Single administration	Main inclusion criteria: Pts, ASA II-III, scheduled for surgery of nondislocated hip fractures following trauma Main exclusion criteria: Refusal by the patient, allergies to local anesthetics, or general contraindications against puncture in the inguinal area, or unable to understand the study protocol because of language or other difficulty
Marhofer 2000¹⁰⁵	Study design: RCT Study period: NR Type of hospital: University hospital Country: Austria Financial support: NR	Intervention #1: Classification: 3-in-1 nerve block (NS) Intervention: Ropivacaine 0.5% Dosage: 20ml Intervals: Single administration Intervention #2: Classification: 3-in-1 nerve block (NS) Intervention: Bupivacaine 0.5% Dosage: 20ml Intervals: Single administration	Main inclusion criteria: ASA I–III, scheduled for hip surgery after trauma Main exclusion criteria: Refusal by the patient, inability to understand study protocol, allergies to local anesthetics, and contraindications against puncture in the inguinal area
Matot 2003¹⁰⁶	Study design: RCT Study period: Oct-98 to Sep-98 Type of hospital: University hospital Country: Israel Financial support: Financial support provided by institutional and/or departmental sources	Intervention #1: Classification: Epidural analgesia (continuous) Intervention: Bolus: Bupivacaine 0.25%/Methadone; Maintainence: Bupivacaine 0.5%/Methadone Dosage: 7-10mL/4mg; 45mg/16mg Intervals: Continous (24hrs) Intervention #2: Classification: IM analgesia Intervention: Meperidine IM Dosage: 1mg per kg Intervals: Every 6hrs	Main inclusion criteria: ≥60 yrs with traumatic hip fracture, able to sign informed consent, known CAD or at high risk for CAD Main exclusion criteria: Contraindications to epidural analgesia, suspected allergy to study drugs, acute coronary insufficiency, ECG evidence of left bundle branch block, or ≥ 10 hrs from the time of injury
Monzon 2010¹⁰⁷	Study design: Randomized Controlled Trial Study period: June 2006 to Jan 2008 Type of hospital: University Hospital Country: Argentina Financial support: No conflicts of interest	Intervention #1: Classification: Fasciailiaca compartment block Intervention: 0.25% bupivacaine Dosage: 0.3 ml/kg Intervals: NR Intervention #2: Classification: General Anaesthesia Intervention: IV NSAID analgesics Dosage: NR Intervals: NR	Main inclusion criteria: adult patients more than 65 years old who presented to the ED because of a previously undiagnosed and untreated hip fracture Main exclusion criteria: anatomical abnormalities in the inguinal area different from fracture, known coagulation disorders, a history of allergy to any of the active ingredients used during the study and refusal to participate
Mouzopoulos 2009¹⁰⁸	Study design: RCT Study period: Jul-04 to Mar-08 Type of hospital: General hospital Country: Greece Financial support: NR	Intervention #1: Classification: Fascia iliaca compartment nerve block (CT) Intervention: Bupivacaine Dosage: 0.25mg dose of 0.3mL per kg Intervals: every 24h before and after surgery Intervention #2: Classification: Placebo Intervention: Saline Dosage: NA Intervals: Every 24h before and after surgery	Main inclusion criteria: ≥ 70 yrs, admitted for hip fracture Main exclusion criteria: Delirium at admission, metastatic hip cancer, hx bupivacaine allergy, use of cholinesterase inhibitors, severe coagulopathy, Parkinsonism, epilepsy, levodopa treatment, delay of surgery > 72 hrs after admission, inability to participate in interviews (e.g. dementia, respiratory isolation, intubation, aphasia, coma or terminal illness)
Murgue 2006¹⁰⁹	Study design: Randomized controlled trials Study period: 37622 to 37987 Type of hospital: General hospital Country: France Financial support: NR	Intervention #1: Classification: Femoral nerve block Intervention: Mepivacaine Dosage: 20 cc Intervals: NA Intervention #2: Classification: Analgesia Intervention: IV morphine Dosage: 2 mg Intervals: 1 mg q5 min until p<=4 Intervention #3: Classification: Analgesia Intervention: IV paracetamol + ketoprofen Dosage: 1 g P + 100 mg K Intervals: NA	Main inclusion criteria: Patients with suspected fractured neck of femur admitted to ED; cognitive functioning to assess pain >27 high SES >24 low SES Main exclusion criteria: Contraindications to equimolar mix of nitrous oxide/O2; contraindications to femoral block; allergy to morphine and/or paracetamol/ketoprofene; known renal insufficiency; already receiving morphine Rx
Pedersen 2008¹¹⁹	Study design: Retrospective cohort study Study period: Jan-03 to Mar-04 Type of hospital: University hospital Country: Denmark Financial support: No external funding	Intervention #1: Classification: 3-in-1 nerve block Intervention: Bupivacaine Dosage: Bolus: 100mg; Maintainence: 50mg Intervals: Single administration; continuous (every 8hrs) Intervention #2: Classification: Analgesia Intervention: Preoperative: Morphine SC or tablets; Postoperative: Morphine SR tablets/acetaminophen or ibuprofen Dosage: 2.5-5mg/10-20mg; 1g/or 400mg Intervals: Every 12hrs; every 8hr/or every 12hrs	Main inclusion criteria: Pts undergoing surgery for a nonpathological, low-energy hip fracture Main exclusion criteria: Pts who did not receive a femoral nerve catheter or were not admitted to hip fracture unit
Scheinin 2000¹¹⁰	Study design: RCT Study period: Jan-95 to Jan-97 Type of hospital: University hospital Country: Finland Financial support: Financial support provided by institutional, departmental and/or governmental sources	Intervention #1: Classification: Epidural analgesia (continuous) Intervention: Bupivacaine/Fentanyl Dosage: 1mg per ml + 10ug per ml Intervals: Continuous administration Intervention #2: Classification: IM analgesia Intervention: Oxycodone IM Dosage: 0.1-0.15mg per kg Intervals: On demand (max every 6hrs)	Main inclusion criteria: Elderly pts admitted for surgical repair of a traumatic hip fracture Main exclusion criteria: Known coagulation abnormalities, progressive neurologic diseases, sepsis and skin infections in lumbar region, restless or uncooperative (e.g., dementia), or significant conduction abnormalities or no sinus rhythm
Segado Jiménez 2009¹¹¹	Study design: RCT Study period: May 2008 to Dec 2008 Type of hospital: University hospital Country: Spain Financial support: NR	Intervention #1: Classification: Obturator/ Femoral cutaneous nerve block Intervention: NR Dosage: NR Intervals: NR Intervention #2: Classification: Obturator nerve block Intervention: NR Dosage: NR Intervals: NR Intervention #3: Classification: IV analgesia Intervention: NR Dosage: NR Intervals: NR	Main inclusion criteria: Patients undergoing hip surgery with subarachnoid blockage Main exclusion criteria: General anesthesia, IV analgesic drugs during surgery, untreated chronic pain, arrythmias/MI, or neurological disorders
Segado Jimenez 2010¹¹²	Study design: Randomized Controlled Trial Study period: 2009 to 2010 Type of hospital: University Hospital Country: Spain Financial support: No funding	Intervention #1: Classification: Fascia iliaca compartment block Intervention: Bupivacaine 0.5% Dosage: 30 ml Intervals: NR Intervention #2: Classification: Obturator/femoralcutaneous nerves block Intervention: Bupivacaine 0.5% Dosage: 15ml / 5 ml Intervals: NR Intervention #3: Classification: General Anaesthesia Intervention: NR Dosage: NR Intervals: NR	Main inclusion criteria: patients with hip surgery, total or partial arthroplasty, and osteosynthesis of femor Main exclusion criteria: patients with previous traetment for chronic pain, ischemic cardiopathic, or arrhythmia, psychiatric and neurodegenerative diseases, poor collaboration and comprehension, allergy to local anaethetics, and contraindication to local/regional anaethetics
Spansberg 1996¹¹³	Study design: RCT Study period: NR Type of hospital: University hospital Country: Denmark Financial support: NR	Intervention #1: Classification: Lumbar plexus block (NS) Intervention: Bolus: Bupivacaine 0.5%; Maintenence: Bupivacaine 0.25% Dosage: 0.4mL per kg; 0.14mL per kg per hr Intervals: Single administration; Continuous administration Intervention #2: Classification: Placebo Intervention: Bolus: Saline; Maintainence: Saline Dosage: 0.4mL per Kg; 0.14mL per kg per hr Intervals: Continuous administration	Main inclusion criteria: Pts with femoral neck fractures Main exclusion criteria: NR
Tuncer 2003¹¹⁴	Study design: RCT Study period: NR Type of hospital: University hospital Country: Turkey Financial support: NR	Intervention #1: Classification: 3-in-1 nerve block (NS) Intervention: Bolus: Lidocaine 2%/Maintainence: Bupivacaine 0.125%; PCA bolus: Bupivaciane 0.125% Dosage: 30ml; 4ml per hr; 3ml Intervals: Single administration; Continuous administration; Patient cotrolled bolus on demand Intervention #2: Classification: IV analgesia Intervention: Morphine IV Dosage: 1mg Intervals: On demand	Main inclusion criteria: Pts, ASA I–II, scheduled for trochanteric fracture repair Main exclusion criteria: Pts with coagulation abnormalities, <18 or >80 yrs, wt <50 or >100 kg, suspected allergy to bupivacaine or opioids, previous analgesic treatment with opioids, inability to understand pain scales or use a patient controlled analgesia device
Turker 2003¹¹⁵	Study design: RCT Study period: NR Type of hospital: University hospital Country: Turkey Financial support: NR	Intervention #1: Classification: Psoas compartment block (NS) Intervention: Bupivacaine 0.5% Dosage: 30ml Intervals: Single administration Intervention #2: Classification: Epidural anesthesia (single) Intervention: Bupivacaine 0.5% Dosage: 15ml Intervals: Single administration	Main inclusion criteria: Pts, ASA I–III, scheduled for unilateral hip surgery Main exclusion criteria: Contraindications to regional anesthesia, suspected allergy to any local anesthetic, dementia preventing proper comprehension, and refusal of the procedure
Yun 2009¹¹⁶	Study design: Randomized controlled trials Study period: 39264 to 39417 Type of hospital: University hospital Country: Korea Financial support: NR	Intervention #1: Classification: Fascia iliaca compartment nerve block (CT) Intervention: Ropivacaine Dosage: 30 mL 3.75 mg/mL 2-3 min Intervals: Single dose Intervention #2: Classification: Analgesia Intervention: Alfentanil Dosage: 10 ug/kg bolus; 0.25 ug/kg/min 2 min Intervals: Single dose	Main inclusion criteria: Patients with an isolated femoral neck fracture scheduled to undergo either compression hip screw or hip replacement surgery. Main exclusion criteria: A suspected allergy to amide local anaesthetics; haemorrhagic diathesis; periperal neuropathy or mental disorders.

: ASA = American Society of Anesthesiology; CT = clinical touch; IM = intramuscular; IV = intravenous; NR = NR; NS = nerve stimulation; RCT = randomized controlled trial; US = ultrasound

From: Appendix E, Description of Included Studies

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Abou-Setta AM, Beaupre LA, Jones CA, et al. Pain Management Interventions for Hip Fracture [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2011 May. (Comparative Effectiveness Reviews, No. 30.) Table E-5, Nerve blocks.
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