Iliopsoas Nerve Block and Femoral Nerve Block in Hip Fracture Surgeries

Comparison Between Iliopsoas Nerve Block and Femoral Nerve Block in Hip Fracture Surgeries

This study aims to compare iliopsoas nerve Block (IPB) to femoral nerve block (FNB) regarding pain control, patient satisfaction, and early ambulation in patients undergoing hip fracture surgeries

Study Overview

• Status: Recruiting
• Conditions: Femoral Nerve Block; Iliopsoas Nerve Block; Hip Fracture Surgeries
• Intervention / Treatment: Drug: Iliopsoas nerve block; Drug: Femoral nerve block

Detailed Description

Hip fractures are among the most frequent fractures seen in the emergency department and orthopedic trauma teams. The terms hip fracture and neck of femur fracture are used synonymously. Both terms describe a proximal femur fracture between the femoral head and 5 cm distal to the lesser trochanter.

Iliopsoas nerve Block (IPB) is a promising motor-sparing analgesic technique that selectively targets the sensory branches of the hip joint originating from the femoral nerve and accessory obturator nerve, sparing the motor supply of quadriceps muscles.

A femoral nerve block (FNB) is a simple nerve block that can be performed easily without or under ultrasound guidance. Under ultrasound guidance, the femoral artery and femoral nerve were identified clearly, and a needle was inserted using an in-plane approach from the lateral to the medial direction. Once the needle tip's position was confirmed, 10 ml of 0.5% bupivacaine was injected adjacent to the femoral nerve.

• Study Type: Observational
• Enrollment (Estimated): 80

Contacts and Locations

• Study Contact: Name: Hazem K Saeed, Master; Phone Number: 00201016056123; Email: hazem.khaled@med.asu.edu.eg

Study Locations

• Egypt
  • Cairo, Egypt, 11591
    • Recruiting
    • Ain shams university
    • Contact: Hazem K Saeed, Master; Phone Number: 00201016056123; Email: hazem.khaled@med.asu.edu.eg
    • Sub-Investigator: Mohamed I Shahata, MD
    • Sub-Investigator: Adel M Al Ansary, MD
    • Sub-Investigator: Rania H Abdelhafiez, MD
    • Sub-Investigator: Ibrahim M El-sherif, MD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

This prospective, single-blind cohort study will be conducted on 80 patients scheduled for elective surgical correction of hip fracture after obtaining approval from the Research Ethical Committee of Ain Shams University. It will be conducted in the assembled operation rooms in Ain Shams University Hospitals.

Description

Inclusion Criteria:

• Age from 18 to 65 years.
• Both sexes.
• American Society of Anesthesiologists (ASA) physical status I and II.
• Patients who are scheduled for elective surgical correction of hip fracture either through open fracture internal fixation (ORIF), partial hip arthroplasty or total hip arthroplasty.

Exclusion Criteria:

• Refusal to participate.
• Coagulopathy.
• Patients with a history of drug allergies to study drugs.
• Inability to cooperate.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Iliopsoas nerve block group; Patients will receive an Iliopsoas nerve block using 10 ml of bupivacaine 0.5%.	Drug: Iliopsoas nerve block; Patients will receive an Iliopsoas nerve block using 10 ml of bupivacaine 0.5%.; Other Names: Bupivacaine 0.5%
Femoral nerve block group; Patients will receive femoral nerve block using 10 ml of bupivacaine 0.5%.	Drug: Femoral nerve block; Patients will receive femoral nerve block using 10 ml of bupivacaine 0.5%.; Other Names: Bupivacaine 0.5%

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Degree of pain	Each patient will be instructed about postoperative pain assessment with the numeric rating scale (NRS) score. NRS (0 represents "no pain" while 10 represents "the worst pain imaginable"). NRS will be assessed upon arrival at the post-anesthesia care unit (PACU) and at 2, 4, 6,12, 24 post-surgery.	24 hours postoperatively

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Total opioids consumption	Intravenous pethidine (25mg) will be given to be repeated after 15 min if no response up to a maximum dose of 50 mg In case of moderate to sever pain.	24 hours postoperatively
Assessment of quadriceps strength	The quadriceps strength will be assessed using the manual muscle testing (MMT) grade (0-5; 0: no muscle contraction, 1: muscle contraction present but unable move joint, 2: able to move joint but not resist gravity, 3: able to resist gravity but not bear substantial resistance, 4: able to resist some level of substantial resistance, 5: able to resist full resistance).	24 hours postoperatively
Time of ambulation	Time of ambulation will be recorded from the end of surgery till walking or moving from place to place	24 hours postoperatively
Patients' satisfaction	Degree of patient satisfaction will be assessed on a 5-point Likert scale patient satisfaction (1, extremely dissatisfied; 2, unsatisfied; 3, neutral; 4, satisfied; 5, extremely satisfied)	24 hours postoperatively
Incidence of complications	Any complication will be recorded.	24 hours postoperatively

Collaborators and Investigators

• Sponsor: Ain Shams University

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2025
• Primary Completion (Estimated): February 1, 2026
• Study Completion (Estimated): February 1, 2026

Study Registration Dates

• First Submitted: February 25, 2025
• First Submitted That Met QC Criteria: February 25, 2025
• First Posted (Actual): March 25, 2025

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: March 1, 2025
• Last Verified: March 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Wounds and Injuries; Leg Injuries; Femoral Fractures; Hip Injuries; Fractures, Bone; Hip Fractures; Physiological Effects of Drugs; Peripheral Nervous System Agents; Anesthetics, Local; Anesthetics; Central Nervous System Depressants; Sensory System Agents; Bupivacaine
• Other Study ID Numbers: FMASU MD38/2025

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: The data will be available upon a reasonable request from the corresponding author after the end of study for one year.
• IPD Sharing Time Frame: After the end of study for one year.
• IPD Sharing Access Criteria: The data will be available upon a reasonable request from the corresponding author.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No