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July 1, 2019BMC GeriatricsOpen Access

Fascia iliaca block in the emergency department for hip fracture: a randomized, controlled, double-blind trial

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Why the study?

Most previous trials reporting analgesic benefit with fascia iliaca block for hip fracture pain were unblinded, carrying high risks of performance, selection, and detection biases.

Does fascia iliaca block improve pain scores in elderly hip fracture patients who received prehospital morphine?

Population

Thirty ASA I-III hip fracture patients over 70 years old who received prehospital morphine

Comparison

Fascia iliaca block with bupivacaine and epinephrine vs sham injection with normal saline

Design

Randomized, controlled, double-blind trial

Follow-up

24 h

Authors

MPMathieu PasquierInternational Commission on Radiation Units and MeasurementsPTPatrick TafféCentre universitaire de médecine générale et santé publique, LausanneOHOlivier HügliUniversity Hospital of Lausanne

Discussion

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Implication

Double-blind RCT shows landmark fascia iliaca block adds no analgesia after morphine in hip fracture; challenges unblinded evidence and leaves adoption open pending larger trials.

Structured PICO

Does fascia iliaca block improve pain scores in elderly hip fracture patients who received prehospital morphine?

P
Population
30 ASA I-III hip fracture patients over 70 years old, who received prehospital morphine
I
Intervention
Fascia iliaca block using 30 ml of bupivacaine 0.5% with epinephrine 1:200,000 administered by emergency medicine physicians using an anatomic landmark-based technique
C
Comparator
Sham injection with normal saline
O
Outcome
Comparison between groups of the longitudinal pain score profiles at rest over the first 45 min following the procedure (numeric rating scale, 0-10)patient reported

Fascia iliaca block using anatomic landmarks did not provide supplementary analgesia for elderly hip fracture patients who had already received prehospital morphine.

Limitations

  • Small sample size

Cite This Study

Pasquier et al. (2019) studied this question.

synapsesocial.com/papers/6a6fb05326a7f98052dc4e1bhttps://doi.org/10.1186/s12877-019-1193-0
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1EFFICACY OF FASCIA ILIACA BLOCK FOR ACUTE PAIN MANAGEMENT IN PATIENTS WITH HIP FRACTURES. A PROSPECTIVE COHORT STUDY2024
  2. 2Fascia Iliaca Block Decreases Hip Fracture Postoperative Opioid Consumption: A Prospective Randomized Controlled Trial2019 · 52 citations
  3. 3Analgesia in hip fractures. Do fascia-iliac blocks make any difference?2016 · 54 citations
  4. 4Fascia iliaca block for pain relief from proximal femoral fracture in the emergency department: a review of the literature2014 · 68 citations
  5. 5Pain Score after Fascia Iliaca Compartment Block for Acute PAIN Management in Hip Fractures at Tertiary Care Hospital2025