The Role of Precision Anesthesia Strategy on Perioperative Organ Protection in Hip Surgery [PASPOP]
NCT ID: NCT06696404
Last Updated: 2025-04-30
Study Results
Results pending
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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Recruitment Status
COMPLETED
Clinical Phase
NA
Total Enrollment
90 participants
Study Classification
INTERVENTIONAL
Study Start Date
2024-12-01
Study Completion Date
2025-04-05
Brief Summary
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The goal of this clinical trial is to investigate the effect of three anesthetic strategies on organ protection in elderly patients undergoing hip fracture surgery.
The main questions it aims to answer are: 1.Does the nerve block anesthesia group have a protective effect on the incidence of postoperative delirium in elderly patients undergoing hip surgery? 2.Does the nerve block anesthesia group also provide protective effects on other organs for elderly patients undergoing hip surgery? 3.What effects will these anesthetic strategies have on short-term and long-term prognosis of elderly patients undergoing hip surgery?
The investigators will compare it with the spinal anesthesia group and the general anesthesia group to see which has a better protective effect on organs.
Participants will undergo preoperative interviews and will be interviewed twice daily, in the morning and evening, from postoperative day 1 to 7 or until discharge, to assess the occurrence of delirium and cognitive levels, pain intensity, and sleep status.
Interventions:
1. Nerve block anesthesia group (NA group): Combined Lumbar and Sacral Plexus Block + sedation or laryngeal mask anesthesia
2. General anesthesia group (GA group): General anesthesia (Endotracheal intubation) + iliac fascial block
3. Spinal anesthesia group (SA group): Spinal anesthesia without any nerve blockade
The main questions it aims to answer are: 1.Does the nerve block anesthesia group have a protective effect on the incidence of postoperative delirium in elderly patients undergoing hip surgery? 2.Does the nerve block anesthesia group also provide protective effects on other organs for elderly patients undergoing hip surgery? 3.What effects will these anesthetic strategies have on short-term and long-term prognosis of elderly patients undergoing hip surgery?
The investigators will compare it with the spinal anesthesia group and the general anesthesia group to see which has a better protective effect on organs.
Participants will undergo preoperative interviews and will be interviewed twice daily, in the morning and evening, from postoperative day 1 to 7 or until discharge, to assess the occurrence of delirium and cognitive levels, pain intensity, and sleep status.
Interventions:
1. Nerve block anesthesia group (NA group): Combined Lumbar and Sacral Plexus Block + sedation or laryngeal mask anesthesia
2. General anesthesia group (GA group): General anesthesia (Endotracheal intubation) + iliac fascial block
3. Spinal anesthesia group (SA group): Spinal anesthesia without any nerve blockade
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Detailed Description
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Background: Over 10 million hip fractures happen per year globally, which lead to a burden on patients, their families, and healthcare systems.98% hip fracture patients require orthopedic surgery. Hip fracture patients are typically elderly and often have multiple comorbidities, decreased organ function, poor physical tolerance, high anesthesia risks, and slow postoperative recovery. Perioperative blood loss is considerable during hip surgery, and the stress response is significant, often leading to severe postoperative pain, which can result in organ damage and complications. These patients pose challenges to anesthesia management, but at the same time, making the anesthetic care episode a major opportunity to impact outcomes.In clinical practice, general anesthesia and spinal anesthesia are the two most commonly used anesthesia strategies. However, current domestic and international studies believe that there is no difference in outcomes for patients undergoing hip surgery under these two strategies. With the advancement of medical science, nerve blocks, due to precise action on the surgical area and effective suppression of postoperative pain, are increasingly applied in clinical settings. When combined with light general anesthesia, nerve blocks can meet surgical requirements. Nerve blocks can reduce quadriceps spasms, decrease stress responses, help maintain hemodynamic stability, and thus might have potential organ-protective effects. Due to the inconsistent clinical research outcomes regarding nerve blocks, coupled with a lack of high-quality study results, the investigators plan to conduct this study to explore the anesthetic strategy with the most prognostic improvement value for patients undergoing hip surgery. So, it will fill critical evidence gaps to inform policy and practice.
Purpose: The purpose of this study is to explore, in the real world, which anesthesia strategy has more organ-protective effects and accelerates postoperative recovery for patients undergoing hip surgery.
Research Design: A prospective randomized three-arm parallel-group double-center exploratory trial with blinded end point evaluation.
Primary hypothesis is that participantis who receive combined lumbar plexus and sacral plexus block + sedation or laryngeal mask anaesthesia will demonstrate improved recovery after randomisation compared with participants who receive general anaesthesia or spinal anesthesia.
Research population: Elderly patients with acute hip fractures requiring surgical treatment.
Interventions:
Participants randomly assigned to NA or GA or SA group in a 1:1:1 ratio.
1. Nerve block anesthesia group (NA group): Combined Lumbar Plexus and Sacral Plexus Block + sedation or laryngeal mask anesthesia. Participants assigned to the NA group will receive lumbar-sacral plexus block combined with laryngeal mask anesthesia. The lumbar-sacral plexus block (0.33% ropivacaine 30ml+20ml) will be performed under the guidance of an ultrasound or nerve stimulator, and the effectiveness of the block will be assessed 20 minutes after the nerve block. Subsequently, participants will undergo sedation or laryngeal mask anesthesia.
2. General anesthesia group (GA group): General anesthesia + iliac fascial block .Participants assigned to the GA group will receive iliac fascial block combined with endotracheal intubation general anesthesia. The iliac fascial block (0.33% ropivacaine 30ml) will be performed under the guidance of an ultrasound or nerve stimulator, and the effectiveness of the block will be assessed 20 minutes after the nerve block. Subsequently, participants will undergo endotracheal intubation general anesthesia.
3. Spinal anesthesia group (SA group):Spinal anesthesia without any nerve blockade. Participants assigned to the SA group will receive spinal anesthesia with or without sedation. Spinal anesthesia is The spinal puncture site is at L2-3 or L3-4. After the puncture needle reaches the subarachnoid space, 1% ropivacaine 0.8-2 ml, totaling 8-20mg, is injected. Depending on the center's practice, it may be replaced with an equivalent dose of bupivacaine .
Statistical analysis:
This study employed R Studio software version 4.3.3 (R Project for Statistical Computing) for data analysis. The specific methodologies are detailed below:
Analysis Principles Primary analysis set: Intent-to-treat (ITT) analysis Randomization method: Stratified randomization by study center
Data Distribution Assessment Normality of continuous variables was evaluated using the Shapiro-Wilk test Normally distributed data: Presented as mean ± standard deviation (Mean ± SD) Non-normally distributed data: Presented as median (interquartile range, Median \[IQR\])
Intergroup comparison methods Continuous variables
For normally distributed data:
Intergroup comparisons among three groups were performed using one-way analysis of variance (ANOVA).
When ANOVA showed significant differences (P \< 0.05), pairwise comparisons were conducted using Student's t-test with Bonferroni correction.
For non-normally distributed data:
Intergroup comparisons were performed using the Kruskal-Wallis nonparametric test.
When significant differences were detected, pairwise comparisons were conducted using the Mann-Whitney U test.
Median differences were calculated using Hodges-Lehmann estimators with 95% confidence intervals (95% CI).
Categorical variables were presented as frequency (percentage, n (%)), Intergroup comparisons were performed using chi-square test (χ² test) or Fisher's exact test (for small sample sizes).
Statistical Significance Criteria:
All tests were two-sided, Significance threshold: P \< 0.05.
Multiple comparison adjustment: When performing multiple pairwise comparisons, the significance level (α) was adjusted to 0.05/number of comparisons (Bonferroni method)
Study end points will be assessed via in-person interview (during hospitalisation), medical record review, telephone interview(after hospital discharge).
This study is designed as a Pilot study to provide data reference for future large-sample studies. The study plans to include 30 patients per group, totaling 90 patients across three groups.
Statistical Analysis: The statistical analysis software used was SAS 9.4. ① For the primary outcome measures, continuous variables were analyzed and expressed using standard deviation mean or interquartile range median, and the distribution type of the data was assessed for normality. Categorical variables were represented by counts and percentages. A modified intention-to-treat (ITT) analysis was employed. Randomization was stratified by hospital. The risk of the primary outcome was compared within each group. Additionally, the primary outcome measures could also be analyzed using a generalized linear model to adjust for potential confounding factors, Risk Ratio (crude, adjusted), and their 95% CI. The model was adjusted for the type of surgery and sensitivity analysis was performed to clarify the impact of data missingness on the robustness of the model. ② For the analysis of secondary outcome measures, depending on the variable situation, different types of variables were analyzed using generalized linear models, generalized estimating equations, Winratio, and COX regression, respectively.
Analysis of Data: All analyses were two-tailed tests, with a statistically significant difference set at P\<0.05.
Expected test progress: 30 days
Purpose: The purpose of this study is to explore, in the real world, which anesthesia strategy has more organ-protective effects and accelerates postoperative recovery for patients undergoing hip surgery.
Research Design: A prospective randomized three-arm parallel-group double-center exploratory trial with blinded end point evaluation.
Primary hypothesis is that participantis who receive combined lumbar plexus and sacral plexus block + sedation or laryngeal mask anaesthesia will demonstrate improved recovery after randomisation compared with participants who receive general anaesthesia or spinal anesthesia.
Research population: Elderly patients with acute hip fractures requiring surgical treatment.
Interventions:
Participants randomly assigned to NA or GA or SA group in a 1:1:1 ratio.
1. Nerve block anesthesia group (NA group): Combined Lumbar Plexus and Sacral Plexus Block + sedation or laryngeal mask anesthesia. Participants assigned to the NA group will receive lumbar-sacral plexus block combined with laryngeal mask anesthesia. The lumbar-sacral plexus block (0.33% ropivacaine 30ml+20ml) will be performed under the guidance of an ultrasound or nerve stimulator, and the effectiveness of the block will be assessed 20 minutes after the nerve block. Subsequently, participants will undergo sedation or laryngeal mask anesthesia.
2. General anesthesia group (GA group): General anesthesia + iliac fascial block .Participants assigned to the GA group will receive iliac fascial block combined with endotracheal intubation general anesthesia. The iliac fascial block (0.33% ropivacaine 30ml) will be performed under the guidance of an ultrasound or nerve stimulator, and the effectiveness of the block will be assessed 20 minutes after the nerve block. Subsequently, participants will undergo endotracheal intubation general anesthesia.
3. Spinal anesthesia group (SA group):Spinal anesthesia without any nerve blockade. Participants assigned to the SA group will receive spinal anesthesia with or without sedation. Spinal anesthesia is The spinal puncture site is at L2-3 or L3-4. After the puncture needle reaches the subarachnoid space, 1% ropivacaine 0.8-2 ml, totaling 8-20mg, is injected. Depending on the center's practice, it may be replaced with an equivalent dose of bupivacaine .
Statistical analysis:
This study employed R Studio software version 4.3.3 (R Project for Statistical Computing) for data analysis. The specific methodologies are detailed below:
Analysis Principles Primary analysis set: Intent-to-treat (ITT) analysis Randomization method: Stratified randomization by study center
Data Distribution Assessment Normality of continuous variables was evaluated using the Shapiro-Wilk test Normally distributed data: Presented as mean ± standard deviation (Mean ± SD) Non-normally distributed data: Presented as median (interquartile range, Median \[IQR\])
Intergroup comparison methods Continuous variables
For normally distributed data:
Intergroup comparisons among three groups were performed using one-way analysis of variance (ANOVA).
When ANOVA showed significant differences (P \< 0.05), pairwise comparisons were conducted using Student's t-test with Bonferroni correction.
For non-normally distributed data:
Intergroup comparisons were performed using the Kruskal-Wallis nonparametric test.
When significant differences were detected, pairwise comparisons were conducted using the Mann-Whitney U test.
Median differences were calculated using Hodges-Lehmann estimators with 95% confidence intervals (95% CI).
Categorical variables were presented as frequency (percentage, n (%)), Intergroup comparisons were performed using chi-square test (χ² test) or Fisher's exact test (for small sample sizes).
Statistical Significance Criteria:
All tests were two-sided, Significance threshold: P \< 0.05.
Multiple comparison adjustment: When performing multiple pairwise comparisons, the significance level (α) was adjusted to 0.05/number of comparisons (Bonferroni method)
Study end points will be assessed via in-person interview (during hospitalisation), medical record review, telephone interview(after hospital discharge).
This study is designed as a Pilot study to provide data reference for future large-sample studies. The study plans to include 30 patients per group, totaling 90 patients across three groups.
Statistical Analysis: The statistical analysis software used was SAS 9.4. ① For the primary outcome measures, continuous variables were analyzed and expressed using standard deviation mean or interquartile range median, and the distribution type of the data was assessed for normality. Categorical variables were represented by counts and percentages. A modified intention-to-treat (ITT) analysis was employed. Randomization was stratified by hospital. The risk of the primary outcome was compared within each group. Additionally, the primary outcome measures could also be analyzed using a generalized linear model to adjust for potential confounding factors, Risk Ratio (crude, adjusted), and their 95% CI. The model was adjusted for the type of surgery and sensitivity analysis was performed to clarify the impact of data missingness on the robustness of the model. ② For the analysis of secondary outcome measures, depending on the variable situation, different types of variables were analyzed using generalized linear models, generalized estimating equations, Winratio, and COX regression, respectively.
Analysis of Data: All analyses were two-tailed tests, with a statistically significant difference set at P\<0.05.
Expected test progress: 30 days
Conditions
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Elderly (People Aged 65 or More)
Hip Fracture
Delirium - Postoperative
Organ Protection
Nerve Block
Study Design
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Allocation Method
RANDOMIZED
Intervention Model
PARALLEL
1. Nerve block anesthesia group (NA group): Combined Lumbar Plexus(0.33% ropivacaine 30ml)and Sacral Plexus Block(0.33% ropivacaine 20ml) + sedation or laryngeal mask anesthesia
2. General anesthesia group (GA group): General anesthesia (Endotracheal intubation) + iliac fascial block(0.33% ropivacaine 30ml)
3. Spinal anesthesia group (SA group): Spinal anesthesia with ropivacaine 8-20 mg or an equivalent dose of Bupivacaine.
2. General anesthesia group (GA group): General anesthesia (Endotracheal intubation) + iliac fascial block(0.33% ropivacaine 30ml)
3. Spinal anesthesia group (SA group): Spinal anesthesia with ropivacaine 8-20 mg or an equivalent dose of Bupivacaine.
Primary Study Purpose
SUPPORTIVE_CARE
Blinding Strategy
SINGLE
Outcome Assessors
The statistician is blinded to group assignment.
Study Groups
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NA group
Nerve block anesthesia group(NA) Intervention: combined Lumbar Plexus and Sacral Plexus Block, with sedation or laryngeal mask anesthesia (induction with Propofol 1-3mg/kg, Sufentanil 0.1-0.4ug/kg)
Group Type
EXPERIMENTAL
Combined Lumbar Plexus and Sacral Plexus Block
Intervention Type
PROCEDURE
This intervention of Combined Lumbar Plexus and Sacral Plexus Block is assigned to Nerve block anesthesia group (NA group): A combined Lumbar Plexus Block (0.33% Ropivacaine 30ml) and Sacral Plexus Block (0.33% Ropivacaine 20ml) administered as a single injection.
GA group
General anesthesia was performed as an endotracheal intubation combined with iliac fascial block (0.33 ropivacaine 30 ml)
Group Type
ACTIVE_COMPARATOR
iliac fascial block
Intervention Type
PROCEDURE
iliac fascial block administered as a single injection below the iliac fascial with 0.33% ropivacaine 30ml.
SA group
Spinal anesthesia was performed as a standard care of spinal anesthetic
Group Type
ACTIVE_COMPARATOR
spinal anesthesia
Intervention Type
PROCEDURE
Spinal anesthesia was performed as a standard care of spinal anesthetic. The spinal puncture site is at L2-3 or L3-4. After the puncture needle reaches the subarachnoid space, 1% ropivacaine 0.8-2 ml, totaling 8-20mg, is injected. Depending on the center's practice, it may be replaced with an equivalent dose of bupivacaine .
Interventions
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Combined Lumbar Plexus and Sacral Plexus Block
This intervention of Combined Lumbar Plexus and Sacral Plexus Block is assigned to Nerve block anesthesia group (NA group): A combined Lumbar Plexus Block (0.33% Ropivacaine 30ml) and Sacral Plexus Block (0.33% Ropivacaine 20ml) administered as a single injection.
Intervention Type
PROCEDURE
iliac fascial block
iliac fascial block administered as a single injection below the iliac fascial with 0.33% ropivacaine 30ml.
Intervention Type
PROCEDURE
spinal anesthesia
Spinal anesthesia was performed as a standard care of spinal anesthetic. The spinal puncture site is at L2-3 or L3-4. After the puncture needle reaches the subarachnoid space, 1% ropivacaine 0.8-2 ml, totaling 8-20mg, is injected. Depending on the center's practice, it may be replaced with an equivalent dose of bupivacaine .
Intervention Type
PROCEDURE
Other Intervention Names
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Lumbar - Sacral Plexus Block
Lumbosacral Plexus Block
Lumbosacral Plexus Nerve Block
Lumbosacral Regional Nerve Block
Lumbosacral Plexus Regional Block
iliac fascial compartment block
Fascia Iliaca Block
Fascia Iliaca Nerve Block
Fascia Iliaca Block Technique
spinal block
intrathecal anesthesia
Eligibility Criteria
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Inclusion Criteria
1. Aged 65 years and older
2. American Society of Anesthesiologists (ASA) physical status 1 to 3
3. Scheduled for unilateral hip surgery
2. American Society of Anesthesiologists (ASA) physical status 1 to 3
3. Scheduled for unilateral hip surgery
Exclusion Criteria
1. Have psychiatric disorders or cognitive impairments, or are unable to understand the scale
2. Have a heart failure history (EF \< 40) or a history of AMI in 3 months
3. Complex injuries: multiple fractures, chest, abdomen, pelvic and sacral trauma, head trauma, etc.
4. Combined with respiratory failure or hepatic failure (Child-Pugh C) or renal failure (rely on dialysis treatment)
5. Nerve block contraindication: puncture site infection, peripheral neuropathy, regional anesthetic allergy, etc.
6. Contraindications of intraspinal anesthesia: coagulation dysfunction, thrombocytopenia, intraspinal space occupying, infection of puncture site, etc.
7. Relative contraindications of general anesthesia: known difficult airway, malignant hyperthermia, etc.
8. Enrolled in another randomized clinical trial
2. Have a heart failure history (EF \< 40) or a history of AMI in 3 months
3. Complex injuries: multiple fractures, chest, abdomen, pelvic and sacral trauma, head trauma, etc.
4. Combined with respiratory failure or hepatic failure (Child-Pugh C) or renal failure (rely on dialysis treatment)
5. Nerve block contraindication: puncture site infection, peripheral neuropathy, regional anesthetic allergy, etc.
6. Contraindications of intraspinal anesthesia: coagulation dysfunction, thrombocytopenia, intraspinal space occupying, infection of puncture site, etc.
7. Relative contraindications of general anesthesia: known difficult airway, malignant hyperthermia, etc.
8. Enrolled in another randomized clinical trial
Minimum Eligible Age
65 Years
Eligible Sex
ALL
Accepts Healthy Volunteers
Yes
Sponsors
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Army Medical Center of PLA
OTHER_GOV
Sponsor Role
collaborator
Shanghai Jiao Tong University Affiliated Sixth People's Hospital
OTHER
Sponsor Role
lead
Responsible Party
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Tao Xu
Dr
Responsibility Role
PRINCIPAL_INVESTIGATOR
Locations
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Arm Medical Center of PLA
Chongqing, Chongqing Municipality, China
Site Status
Shanghai 6th People's hospital
Shanghai, Shanghai Municipality, China
Site Status
Countries
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China
References
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Guay J, Kopp S. Peripheral nerve blocks for hip fractures in adults. Cochrane Database Syst Rev. 2020 Nov 25;11(11):CD001159. doi: 10.1002/14651858.CD001159.pub3.
Reference Type
BACKGROUND
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Kim CH, Yang JY, Min CH, Shon HC, Kim JW, Lim EJ. The effect of regional nerve block on perioperative delirium in hip fracture surgery for the elderly: A systematic review and meta-analysis of randomized controlled trials. Orthop Traumatol Surg Res. 2022 Feb;108(1):103151. doi: 10.1016/j.otsr.2021.103151. Epub 2021 Nov 23.
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Cai L, Song Y, Wang Z, She W, Luo X, Song Y. The efficacy of fascia iliaca compartment block for pain control after hip arthroplasty: A meta-analysis. Int J Surg. 2019 Jun;66:89-98. doi: 10.1016/j.ijsu.2018.12.012. Epub 2019 Jan 24.
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Gao Y, Tan H, Sun R, Zhu J. Fascia iliaca compartment block reduces pain and opioid consumption after total hip arthroplasty: A systematic review and meta-analysis. Int J Surg. 2019 May;65:70-79. doi: 10.1016/j.ijsu.2019.03.014. Epub 2019 Mar 25.
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Memtsoudis SG, Cozowicz C, Bekeris J, Bekere D, Liu J, Soffin EM, Mariano ER, Johnson RL, Go G, Hargett MJ, Lee BH, Wendel P, Brouillette M, Kim SJ, Baaklini L, Wetmore DS, Hong G, Goto R, Jivanelli B, Athanassoglou V, Argyra E, Barrington MJ, Borgeat A, De Andres J, El-Boghdadly K, Elkassabany NM, Gautier P, Gerner P, Gonzalez Della Valle A, Goytizolo E, Guo Z, Hogg R, Kehlet H, Kessler P, Kopp S, Lavand'homme P, Macfarlane A, MacLean C, Mantilla C, McIsaac D, McLawhorn A, Neal JM, Parks M, Parvizi J, Peng P, Pichler L, Poeran J, Poultsides L, Schwenk ES, Sites BD, Stundner O, Sun EC, Viscusi E, Votta-Velis EG, Wu CL, YaDeau J, Sharrock NE. Peripheral nerve block anesthesia/analgesia for patients undergoing primary hip and knee arthroplasty: recommendations from the International Consensus on Anesthesia-Related Outcomes after Surgery (ICAROS) group based on a systematic review and meta-analysis of current literature. Reg Anesth Pain Med. 2021 Nov;46(11):971-985. doi: 10.1136/rapm-2021-102750. Epub 2021 Aug 25.
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Yoshimura M, Shiramoto H, Koga M, Yoshimatsu A, Morimoto Y. Comparing the effects of peripheral nerve block and general anesthesia with general anesthesia alone on postoperative delirium and complications in elderly patients: a retrospective cohort study using a nationwide database. Reg Anesth Pain Med. 2022 May 30:rapm-2022-103566. doi: 10.1136/rapm-2022-103566. Online ahead of print.
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BACKGROUND
Li T, Li J, Yuan L, Wu J, Jiang C, Daniels J, Mehta RL, Wang M, Yeung J, Jackson T, Melody T, Jin S, Yao Y, Wu J, Chen J, Smith FG, Lian Q; RAGA Study Investigators. Effect of Regional vs General Anesthesia on Incidence of Postoperative Delirium in Older Patients Undergoing Hip Fracture Surgery: The RAGA Randomized Trial. JAMA. 2022 Jan 4;327(1):50-58. doi: 10.1001/jama.2021.22647.
Reference Type
BACKGROUND
Neuman MD, Feng R, Carson JL, Gaskins LJ, Dillane D, Sessler DI, Sieber F, Magaziner J, Marcantonio ER, Mehta S, Menio D, Ayad S, Stone T, Papp S, Schwenk ES, Elkassabany N, Marshall M, Jaffe JD, Luke C, Sharma B, Azim S, Hymes RA, Chin KJ, Sheppard R, Perlman B, Sappenfield J, Hauck E, Hoeft MA, Giska M, Ranganath Y, Tedore T, Choi S, Li J, Kwofie MK, Nader A, Sanders RD, Allen BFS, Vlassakov K, Kates S, Fleisher LA, Dattilo J, Tierney A, Stephens-Shields AJ, Ellenberg SS; REGAIN Investigators. Spinal Anesthesia or General Anesthesia for Hip Surgery in Older Adults. N Engl J Med. 2021 Nov 25;385(22):2025-2035. doi: 10.1056/NEJMoa2113514. Epub 2021 Oct 9.
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BACKGROUND
Griffiths R, Babu S, Dixon P, Freeman N, Hurford D, Kelleher E, Moppett I, Ray D, Sahota O, Shields M, White S. Guideline for the management of hip fractures 2020: Guideline by the Association of Anaesthetists. Anaesthesia. 2021 Feb;76(2):225-237. doi: 10.1111/anae.15291. Epub 2020 Dec 2.
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BACKGROUND
Sciard D, Cattano D, Hussain M, Rosenstein A. Perioperative management of proximal hip fractures in the elderly: the surgeon and the anesthesiologist. Minerva Anestesiol. 2011 Jul;77(7):715-22. Epub 2011 Feb 1.
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BACKGROUND
Vaurio LE, Sands LP, Wang Y, Mullen EA, Leung JM. Postoperative delirium: the importance of pain and pain management. Anesth Analg. 2006 Apr;102(4):1267-73. doi: 10.1213/01.ane.0000199156.59226.af.
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BACKGROUND
Lynch EP, Lazor MA, Gellis JE, Orav J, Goldman L, Marcantonio ER. The impact of postoperative pain on the development of postoperative delirium. Anesth Analg. 1998 Apr;86(4):781-5. doi: 10.1097/00000539-199804000-00019.
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BACKGROUND
Shen Y, Liu W, Zhu Z, Liu S, Cao Y, Yan L, Chen L. Application of a preoperative pain management mode based on instant messaging software in elderly hip fracture patients: a randomized controlled trial. BMC Geriatr. 2023 Mar 30;23(1):186. doi: 10.1186/s12877-023-03905-2.
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BACKGROUND
Foss NB, Kristensen BB, Bundgaard M, Bak M, Heiring C, Virkelyst C, Hougaard S, Kehlet H. Fascia iliaca compartment blockade for acute pain control in hip fracture patients: a randomized, placebo-controlled trial. Anesthesiology. 2007 Apr;106(4):773-8. doi: 10.1097/01.anes.0000264764.56544.d2.
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BACKGROUND
Gou RY, Hshieh TT, Marcantonio ER, Cooper Z, Jones RN, Travison TG, Fong TG, Abdeen A, Lange J, Earp B, Schmitt EM, Leslie DL, Inouye SK; SAGES Study Group. One-Year Medicare Costs Associated With Delirium in Older Patients Undergoing Major Elective Surgery. JAMA Surg. 2021 May 1;156(5):430-442. doi: 10.1001/jamasurg.2020.7260.
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BACKGROUND
Memtsoudis SG, Ma Y, Gonzalez Della Valle A, Besculides MC, Gaber LK, Koulouvaris P, Liu SS. Demographics, outcomes, and risk factors for adverse events associated with primary and revision total hip arthroplasties in the United States. Am J Orthop (Belle Mead NJ). 2010 Aug;39(8):E72-7.
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BACKGROUND
Zhang C, Feng J, Wang S, Gao P, Xu L, Zhu J, Jia J, Liu L, Liu G, Wang J, Zhan S, Song C. Incidence of and trends in hip fracture among adults in urban China: A nationwide retrospective cohort study. PLoS Med. 2020 Aug 6;17(8):e1003180. doi: 10.1371/journal.pmed.1003180. eCollection 2020 Aug.
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Witlox J, Eurelings LS, de Jonghe JF, Kalisvaart KJ, Eikelenboom P, van Gool WA. Delirium in elderly patients and the risk of postdischarge mortality, institutionalization, and dementia: a meta-analysis. JAMA. 2010 Jul 28;304(4):443-51. doi: 10.1001/jama.2010.1013.
Reference Type
BACKGROUND
Other Identifiers
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2024-147-（1）
Identifier Type: -
Identifier Source: org_study_id
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TERMINATED
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Risk Early Warning Management for Postoperative Hip Fracture Rehabilitation and Delirium Prevention in Elderly Patients
NCT06966947
COMPLETED
Evaluating the Addition of Regional Analgesia to Reduce Postoperative Delirium in Patients Having Hip Fracture Surgery.
NCT02689388
TERMINATED
NA
Postoperative Recovery in Elderly Patients Undergoing Hip Hemi-arthroplasty
NCT01934049
UNKNOWN
PHASE4
A Trial To Assess Risk of Delirium in Older Adults Undergoing Hip Fracture Surgery With Spinal or General Anesthesia
NCT02190903
COMPLETED
NA
Deep Neuromuscular Block on Cytokines Release and Postoperative Delirium
NCT02507609
COMPLETED
NA
Low-dose Neuroleptanalgesia for Postoperative Delirium in Elderly Patients
NCT05068180
UNKNOWN
PHASE4
Association of Transversus Abdominis Plane Block (TAPB) with Postoperative Delirium (POD) in Elderly Patients Undergoing Major Gastrointestinal Surgery
NCT06829108
COMPLETED
Prevention of Delirium Among Elderly Patients With Hip Fractures
NCT03470662
COMPLETED
NA
Hip Fracture Surgery in Elderly Patients
NCT01199276
COMPLETED
PHASE2
Elderly Patients Undergoing Surgery During Perioperative Period
NCT07314762
RECRUITING
How Different Sedatives Affect Hip Fracture Patient's Postoperative Delirium
NCT03346226
UNKNOWN
PHASE4
Effect of Rebound Pain on Postoperative Intensive Care Delirium in Patients Undergoing Hip Surgery With Peripheral Nerve Block
NCT07295184
NOT_YET_RECRUITING
A Comparison of Two Pain Control Techniques on Deliruim in Hip Fracture Patients
NCT01547468
WITHDRAWN
NA
Low- vs. Normal-Flow Anesthesia and Delirium After Hip Fracture in the Elderly
NCT06973967
NOT_YET_RECRUITING
Post-operative Delirium (POD) in Patients Undergoing Hip Fracture Surgery
NCT05105906
COMPLETED
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
NCT04654962
UNKNOWN
Delirium in Elderly Patients With Trauma of the Hip
NCT02689024
TERMINATED
PHASE4
Cytokines, POD, Health Status, Older Hip Fracture
NCT05096507
UNKNOWN
Spinal Anesthesia Vs. Neve Block in Risk of Cognitive Decline
NCT06963229
ACTIVE_NOT_RECRUITING
NA
Effect of Intraoperative Sedation on PND in Elderly Patients
NCT04891458
UNKNOWN
NA
Shaping Anesthetic Techniques to Reduce Post-operative Delirium
NCT03133845
COMPLETED
NA
Association Between Preoperative Hyperglycemia and Postoperative Delirium in Geriatric Hip Fracture Patients
NCT06473324
COMPLETED
Postoperative Delirium in the Post-anesthesia Care Unit
NCT06318364
RECRUITING