Use of Anesthetic Block for the Prevention of in Hospital Delirium in Patients of the Orthogeriatric Clinical Care Center of the HUFSFB and HUSJI From 2019 - 2020

NCT ID: NCT04654962

Last Updated: 2020-12-04

Basic Information

• Recruitment Status: UNKNOWN
• Total Enrollment: 160 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2020-10-01
• Study Completion Date: 2021-02-15

Brief Summary

The purpose of this study is to identify the association between analgesic management with blockade of the iliac fascia versus intravenous analgesia with the presence of delirium during hospital stay in patients admitted to the orthogeriatric clinical care center, to determine the opioid consumption of both groups of patients during hospitalization and determine the risk factors that may be associated with a greater presentation of delirium.

Detailed Description

Nowadays, with the increase in the geriatric population, there is evidence of an increase in the prevalent conditions in this group, finding within them fragility hip fractures. Additionally, most of these patients have a large number of associated comorbidities, which may require greater specialization in care.

To reduce the possible complications that may be related, different management protocols have been implemented, including pain management strategies such as preventive analgesics, regional blocks, and early surgery. Conventional treatment with the use of intravenous medications can have unwanted effects in geriatric patients with hip fracture, especially in those with greater comorbidity, since medications such as opioids can cause multiple adverse effects, including delirium. Also, not treating pain properly can cause complications such as depression and ulcers in addition to delirium.

This is why the objective of this study is to define whether there is any association between the presentation of delirium in patients over 65 years of age with hip fracture who undergo iliac fascia block upon admission compared to those who receive only IV analgesia Therefore, this retrospective cohort study will be carried out with which it is sought to contribute to the knowledge to continue carrying out early pain management, with the aim of achieving better pain control, a decrease in opioid consumption and thus having a lower number of patients with delirium during hospitalization.

Conditions

Delirium in Old Age; Fragility Fracture; Hip Fractures

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: OTHER

Study Groups

patients receiving preoperative analgesic management with anesthetic block

This cohort includes all patients that received preoperative anesthetic block for hip fracture surgery as main analgesic management during the study period.

Anesthetic nerve block

Intervention Type: PROCEDURE

iliac fascia block is an analgesic technique that uses local anesthesia, is effective and relatively safe in preoperative management. The target of this block is the femoral and lateral femoral cutaneous nerves; which innervate the anterior aspect of the thigh, as well as the muscle and periosteum that covers the femoral head, neck and proximal femur.

patients receiving conventional preoperative analgesic management

This cohort includes all patients that received conventional preoperative analgesic management (oral, intravenous or intramuscular medication) for hip fracture surgery as main analgesic management during the study period.

No interventions assigned to this group

Interventions

Anesthetic nerve block

iliac fascia block is an analgesic technique that uses local anesthesia, is effective and relatively safe in preoperative management. The target of this block is the femoral and lateral femoral cutaneous nerves; which innervate the anterior aspect of the thigh, as well as the muscle and periosteum that covers the femoral head, neck and proximal femur.

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

• Patients over 65 years of age with a diagnosis of hip fracture due to fragility who are admitted to the Orthogeriatric clinical care center at the Santa Fe de Bogotá Foundation and the San José Infantil University Hospital between January 2019 and December 2020. These two institutions are selected Since they have a model of care for this type of patient, it is similar and therefore comparable.

Exclusion Criteria

• Patients diagnosed with delirium on admission to the emergency room.
• Patients with hip fracture caused by high energy trauma
• Patients with hip fracture related with tumoral disease or metastasis

• Minimum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Fundación Santa Fe de Bogota

OTHER

Sponsor Role: lead

Responsible Party

Jonathan Tihanyi Feldman

Clinical research assistant of the Orthogeriatric Clinical Care Center

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Carlos M Olarte, MD

Role: PRINCIPAL_INVESTIGATOR

Orthopedic surgeon

Locations

Hospital Universitario Fundación Santa fe de Bogotá

Bogotá, , Colombia

Countries

Colombia

Other Identifiers

CEIS-2020-083

Identifier Type: -

Identifier Source: org_study_id