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Fascia Iliaca Block Using Liposomal Bupivacaine for Analgesia After Hip Fracture Surgery

2026년 6월 7일 업데이트: Dong-Xin Wang, Peking University First Hospital

Fascia Iliaca Block Using Liposomal Bupivacaine for Analgesia After Hip Fracture Surgery: a Randomized Trial

Older patients with hip fractures often suffer from severe pain. Inadequate analgesia increases the risk of postoperative delirium, myocardial injury, and other complications. Peripheral nerve block is an important component of multimodal analgesia, but conventional local anesthetics (e.g., plain bupivacaine) provide only approximately 12 hours of analgesic duration, which is far from covering the most painful 72 hours after surgery. Liposomal bupivacaine has a slow-release property, prolonging the analgesic duration up to 72 hours after a single injection. However, its clinical advantages in hip fracture surgery remain controversial. The investigators suppose that, compared with plain bupivacaine alone, preoperative supra-inguinal fascia iliaca block using liposomal bupivacaine combined with plain bupivacaine can further improve analgesia within 72 hours after surgery in older patients undergoing hip fracture surgery, decrease opioid consumption, and improve postoperative recovery quality.

연구 개요

상태

아직 모집하지 않음

정황

개입 / 치료

상세 설명

Hip fracture is a global health concern. Data from 204 countries over the past 30 years show an increasing incidence of hip fractures in people over 55 years old. With population aging, China is projected to have 1.3 million new geriatric hip fracture cases annually by 2050, imposing a heavy burden on individuals, families, and healthcare systems. Timely surgery remains the preferred treatment.

Optimizing analgesia through multimodal strategies can enhance postoperative recovery and shorten hospital stays. Peripheral nerve blocks (PNB), particularly ultrasound-guided femoral nerve block or supra-inguinal fascia iliaca compartment block (FICB), have been shown to reduce pain and opioid consumption after hip surgery. A recent prospective cohort study indicated that better perioperative pain control with PNB is associated with lower opioid needs and shorter hospitalization.

Conventional local anesthetics like ropivacaine or bupivacaine provide analgesia for about 12 hours, which is insufficient for the entire perioperative period. Liposomal bupivacaine, an extended-release formulation, can provide analgesia for up to 72 hours. Some studies have demonstrated benefits of liposomal bupivacaine for nerve blocks in thoracic and hip surgeries, including improved recovery quality, reduced opioid use, and lower pain scores at 24-72 hours. However, evidence remains controversial; several meta-analyses suggest that while statistical differences exist, clinical relevance may be limited.

Inadequate pain control negatively affects postoperative outcomes and is associated with delirium, myocardial injury, and pulmonary complications-especially in vulnerable older patients with reduced physiological reserve and multiple comorbidities. Therefore, this randomized controlled trial aims to investigate whether preoperative FICB using liposomal bupivacaine provides superior perioperative analgesia compared with plain bupivacaine in older (≥55 years) patients undergoing hip fracture surgery.

연구 유형

중재적

등록 (추정된)

148

단계

  • 4단계

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 연락처

연구 연락처 백업

연구 장소

  • 중국
    • Beijing Municipality
      • Beijing, Beijing Municipality, 중국, 100034
        • Peking University First Hospital
        • 연락하다:

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

  • 성인
  • 고령자

건강한 자원 봉사자를 받아들입니다

아니

설명

Inclusion Criteria:

  • Aged ≥ 55 years.
  • Diagnosed as hip fracture and scheduled to undergo hip replacement surgery.
  • Agree to receive regional nerve block and postoperative patient-controlled intravenous analgesia (PCIA).

Exclusion Criteria:

  • Inability to communicate due to visual, auditory, language, or other reasons before surgery.
  • Chronic opioid dependence and long-term use of various types of analgesics (for more than 3 months).
  • Severe coagulation abnormalities (International Normalized Ratio > 1.7, activated partial thromboplastin time exceeding the normal value by more than 4 seconds, platelet count < 80 × 10⁹/L), trauma or infection at the intended puncture site, or severe low back pain.
  • Preoperative severe renal insufficiency (serum creatinine > 442 μmol/L or requiring renal replacement therapy), hepatic insufficiency (Child-Pugh class C), or ASA physical status > IV.
  • Known allergy to local anesthetics.
  • Any other condition that the investigator or attending physician deems unsuitable for participation in the study.

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 치료
  • 할당: 무작위
  • 중재 모델: 병렬 할당
  • 마스킹: 삼루타

무기와 개입

참가자 그룹 / 팔
개입 / 치료
실험적: Liposomal bupivacaine group
Participants in this arm will receive a single preoperative ultrasound-guided supra-inguinal fascia iliaca block. The mixture used for nerve block will consist of 10 mL of 0.5% plain bupivacaine plus 20 mL of liposomal bupivacaine (266 mg), for a total volume of 30 mL. The mixture will be injected after negative aspiration and under real-time ultrasound visualization to confirm correct needle tip position between the fascia iliaca and the iliacus muscle. The block is performed in the preoperative holding area.
의약품: Liposomal bupivacaine (LB)
A single preoperative ultrasound-guided supra-inguinal fascia iliaca block will be perfomed using a mixture of 10 mL of 0.5% plain bupivacaine plus 20 mL of liposomal bupivacaine (266 mg), total volume 30 mL. The mixture will be injected after negative aspiration and under real-time ultrasound visualization to confirm correct needle tip placement between the fascia iliaca and the iliacus muscle. The block will be performed in the preoperative holding area.
활성 비교기: Plain bupivacaine group
Participants in this arm will receive a single preoperative ultrasound-guided supra-inguinal fascia iliaca block. The mixture used for nerve block will consist of 30 mL of 0.5% plain bupivacaine (total 150 mg). The mixture will be injected after negative aspiration and under real-time ultrasound visualization to confirm correct needle tip position between the fascia iliaca and the iliacus muscle. The block is performed in the preoperative holding area.
의약품: Plain bupivacaine
A single preoperative ultrasound-guided supra-inguinal fascia iliaca block will be performed using 30 mL of 0.5% plain bupivacaine (150 mg). The injection will be performed after negative aspiration and under real-time ultrasound guidance to ensure proper spread between the fascia iliaca and the iliacus muscle. The block is performed in the preoperative holding area.

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
The area under curve of pain intensity within 72 hours after surgery
기간: Up to 72 hours after the surgery
Pain intentsity will be assessed with the numeric rating scale (NRS; an 11-point where 0=no pain and 10=the worst pain) at 2, 6, 12 hours and then very 12 hours, until 72 hours after surgey. The area under curve of pain intensity will be calculated using the trapezoidal rule.
Up to 72 hours after the surgery

2차 결과 측정

결과 측정
측정값 설명
기간
Cumulative opioid consumption within 72 hours after surgery
기간: Up to 72 hours after the surgery
Cumulative opioid consumption will be calculated as intravenous morphine equivalent dosage.
Up to 72 hours after the surgery
Incidence of cardiovascular events within 7 days after surgery
기간: Up to 7 days after surgery
Cardiovascular events includes myocardial injury, non-fatal cardiac arrest, and all-cause death.
Up to 7 days after surgery

기타 결과 측정

결과 측정
측정값 설명
기간
수술 후 입원 기간
기간: 수술 후 30일까지
수술 후 입원 기간
수술 후 30일까지
Incidence of moderate-to-severe pain within 72 hours after surgery
기간: Up to 72 hours after surgery
Moderate-to-severe pain is defined as a NRS pain score of 4 or higher at any timpoint.
Up to 72 hours after surgery
The proportion of patients receiving rescue analgesics within 72 hours after surgery.
기간: Up to 72h after surgery
Rescue analgesics are defined as any analgesic drugs other than PCIA, including opioids, acetaminophen, non-steroid anti-inflammatory drugs, and other analgesics.
Up to 72h after surgery
Cumulative score of subjective sleep quality during the first three nights after surgery
기간: Up to three nights after surgery
Subjective sleep quaality will be assessed with the numeric rating scale (NRS; an 11-point where 0=the best sleep and 10=the worst sleep).
Up to three nights after surgery
Quality of recovery at 24 hours after surgery
기간: At 24 hours after surgery
Quality of recovery will be assessed with the quality of recovery-15 (QoR-15; a 15-item questionnaire that evaluat the quality of early postoperative recovery after surgery and anesthesia. Scores range from 0 to 150, with higher scores indicating better quality of recovery).
At 24 hours after surgery
Incidence of acute kidney injuy within 7 days after surgery
기간: Up to 7 days after surgery
Acute kidney injury (AKI) will be diagnosed according to the 2012 KDIGO (Kidney Disease: Improving Global Outcomes) creatinine criteria. guideline . AKI is diagnosed if any one of the following criteria is met: (1) An increase in serum creatinine (SCr) by ≥ 0.3 mg/dL (≥ 26.5 μmol/L) within 48 hours; (2) An increase in serum creatinine to ≥ 1.5 times the baseline value, which is confirmed or presumed to have occurred within the past 7 days.
Up to 7 days after surgery
Incidence of complications within 30 days after surgery
기간: Up to 30 days after surgery
Postoperative complications are generally defined as new-onset conditions that are deemed harmful and required therapeutic intervention, i.e., grade 2 or higher on the Clavien-Dindo classification.
Up to 30 days after surgery

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

스폰서

Peking University First Hospital

수사관

  • 수석 연구원: Dong-Xin Wang, MD, PhD, Peking University First Hospital

간행물 및 유용한 링크

연구에 대한 정보 입력을 담당하는 사람이 자발적으로 이러한 간행물을 제공합니다. 이것은 연구와 관련된 모든 것에 관한 것일 수 있습니다.

일반 간행물

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (추정된)

2026년 7월 1일

기본 완료 (추정된)

2028년 6월 1일

연구 완료 (추정된)

2028년 8월 1일

연구 등록 날짜

최초 제출

2026년 6월 7일

QC 기준을 충족하는 최초 제출

2026년 6월 7일

처음 게시됨 (실제)

2026년 6월 12일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2026년 6월 12일

QC 기준을 충족하는 마지막 업데이트 제출

2026년 6월 7일

마지막으로 확인됨

2026년 6월 1일

추가 정보

이 연구와 관련된 용어

키워드

추가 관련 MeSH 약관

기타 연구 ID 번호

  • 2026R0311

개별 참가자 데이터(IPD) 계획

개별 참가자 데이터(IPD)를 공유할 계획입니까?

아니요

약물 및 장치 정보, 연구 문서

미국 FDA 규제 의약품 연구

아니

미국 FDA 규제 기기 제품 연구

아니

이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .

수술 후 통증에 대한 임상 시험

Liposomal bupivacaine (LB)에 대한 임상 시험

유사한 임상시험 검색

스폰서 및 공동 작업자

건강 상태

약물 개입

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약물 개입

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