- Emergency physicians (EPs) safely began continuous nerve blocks in this group of adults with acute fracture.
- This tactic could help reduce opioid use.
Why this matters
- Hip and rib fractures call for aggressive pain control.
- EPs give single-shot nerve blocks to provide regional anesthesia.
- Continuous blockade might reduce opioid consumption.
- Mean patient age, 65.9 (range, 28-94) years.
- 5 patients required ICU admission.
- Mean duration of blockade, 3.4 days.
- Hourly opioid use fell by 58% after vs before catheter placement.
- Most common complication: dislodged catheter.
- 4 patients developed pneumonia, 2 of whom had hip fracture.
- No pneumothoraces, hemothoraces, catheter-related infections, or hematomas.
- 8 patients were discharged to home with catheter in place.
- Retrospective, observational, single-center cohort study (n=41).
- In 2016, this center decided to offer continuous nerve blocks to a convenience sample of adults with new hip or rib fracture.
- Patients received ultrasound-guided nerve-block over-the-needle catheters and continuous ropivacaine infusion pumps.
- Upon discharge from hospital, patients were offered option to keep catheter and pump running, with ED return visit for removal.
- Researchers reported a range of outcomes to describe their initial experience.
- Funding: None.
- Nonrandomized, non-placebo-controlled study.