Early recovery of basic mobility under femoral nerve block after hip fracture surgery – A propensity score matched pilot study

Ogawa, Takahisa; Seki, Kazuhiko; Tachibana, Tetsuya; Hayashi, Hiroto; Moross, Janelle; Kristensen, Morten Tange; Shirasawa, Shinichi

doi:10.1016/j.injury.2021.07.028

“…A similar study by Pascarella et al 8 found the PENG block in additional to spinal anesthesia to be associated with lower postoperative pain scores and shorter time to ambulation after hip fracture fixation. Another study by Ogawa et al 34 found an association between early ambulation and the use of a femoral nerve block in addition to spinal anesthesia in patients undergoing hip fracture fixation. Unlike the studies by Pascarella and Ogawa, the patients in our study received the LOH block only—no spinal or general anesthesia was given to these patients.…”

Section: Discussionmentioning

confidence: 99%

The Lateral Femoral Cutaneous and Over the Hip (LOH) Block for the Surgical Management of Hip Fractures: A Safe and Effective Anesthetic Strategy

Deemer

¹

,

Furgiuele

²

,

Ganta

³

et al. 2023

Journal of Orthopaedic Trauma

4

1

0

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“…We were able to identify two studies that investigated the effects of PNB use on postoperative ambulation after hip fracture surgery. Ogawa et al 22 investigated short-term mobility outcomes with a 3-day cumulated ambulation score (CAS, scale 0 to 18) that included a combined assessment for three mobility milestones: getting out of bed, sit-to-stand-to-sit from a chair, and walking scored 0 to 2 based on ability to perform independently with or without assistance. 22,23 They found that patients who received PNB in addition to standard epidural anesthesia had higher cumulative 3-day mobility scores than patients receiving only epidural anesthesia (mean 8.7 vs. 7.3, P = 0.048).…”

Section: Discussionmentioning

confidence: 99%

“…We were able to identify two studies that investigated the effects of PNB use on postoperative ambulation after hip fracture surgery. Ogawa et al 22 Cox proportional hazard regression evaluating patient demographic variables along with anesthesia type and PNB use. A hazard ratio above 1.00 indicates that the variable in question increased the likelihood of that event, whereas a hazard ratio less than 1.00 indicates that the variable in question decreased the likelihood of that event.…”

Section: Discussionmentioning

confidence: 99%

“…Ogawa et al 22 investigated short-term mobility outcomes with a 3-day cumulated ambulation score (CAS, scale 0 to 18) that included a combined assessment for three mobility milestones: getting out of bed, sit-to-stand-to-sit from a chair, and walking scored 0 to 2 based on ability to perform independently with or without assistance. 22,23 They found that patients who received PNB in addition to standard epidural anesthesia had higher cumulative 3-day mobility scores than patients receiving only epidural anesthesia (mean 8.7 vs. 7.3, P = 0.048). However, this study was limited by a smaller sample size of only 78 patients, lack of mobility data after 3 days, and lack of milestone-specific comparisons.…”

Section: Discussionmentioning

confidence: 99%

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Peripheral Nerve Block Delays Mobility and Increases Length of Stay in Patients With Geriatric Hip Fracture

Morriss

¹

,

Kerr

²

,

Cunningham

³

et al. 2023

J Am Acad Orthop Surg

2

0

1

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Introduction: Peripheral nerve blocks (PNB) has been increasingly used in the care of patients with geriatric hip fracture to reduce perioperative opiate use and the need for general anesthesia. However, the associated motor palsy may impair patients' ability to mobilize effectively after surgery and subsequently may increase latency to key mobility milestones postoperatively, as well as increase inpatient length of stay (LOS). The aim of this study was to investigate time-tomobility milestones and length of hospital stay between peripheral, epidural, and general anesthesia.Methods: A retrospective review identified 1,351 patients aged 65 years or older who underwent surgery for hip fracture between 2012 and 2018 at a single academic health system. Patients were excluded if baseline nonambulatory, restricted weight-bearing postoperatively, or sustained concomitant injuries precluding mobilization, with a final cohort of 1,013 patients. Time-to-event analyses for discharge and mobility milestones were assessed using univariate Kaplan-Meier and multivariate Cox proportional hazard regression analyses.Results: PNB was associated with delayed postoperative time to ambulation (P , 0.001) and time to out-of-bed (P = 0.029), along with increased LOS (P , 0.001). Epidural anesthesia was associated with less delay to first out-of-bed (P = 0.002), less delay to ambulation (P = 0.001), and overall reduced length of stay (P , 0.001).Discussion: PNB was associated with slower mobilization and longer hospitalization while epidural anesthesia was associated with quicker mobilization and shorter hospital stays. Epidural anesthesia may be a preferable anesthesia choice in patients with geriatric hip fracture when possible.

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“…In recent years, with the development and progress of the concept of rehabilitation, the importance of early functional training after injury surgery has been gradually recognized and accepted [ 6 ]. However, with the rehabilitation training system based on virtual reality technology, patients need to face a different reality and virtual world every day, which is prone to anxiety.…”

Section: Introductionmentioning

confidence: 99%

Effect of Remote Control Augmented Reality Multimedia Technology for Postoperative Rehabilitation of Knee Joint Injury

Li

¹

2022

Computational and Mathematical Methods in Medicine

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This study was aimed at exploring the application value of augmented reality (AR) in postoperative rehabilitation training for patients with knee joint injury. 40 patients who underwent knee joint injury surgery were selected as the research objects, and the patients were randomly divided into two groups: an experimental group (20 cases) and a control group (20 cases). Patients in the experimental group were treated with AR-based rehabilitation methods, while those in the control group were treated with traditional rehabilitation methods. Afterwards, the two groups of patients were compared with various indicators such as pain value, swelling, structural and functional recovery, time to complete weight bearing, time to return to work, and X-ray examination results. The main evaluation tools used were Hospital for Special Surgery (HSS) score and Visual Analogue Scale (VAS) score. The results showed that after six weeks, the HSS score of the control group was 82.88 ± 3.07 , and the HSS score of the experimental group was 85.46 ± 3.21 . The difference between the two groups was statistically significant ( P < 0.05 ). After three months, the HSS score of the control group was 89.96 ± 3.76 , and that of the experimental group was 93.21 ± 4.33 . The difference between the two groups was statistically significant ( P < 0.05 ). There was a significant difference in pain scores between the two groups at 7 days ( 3.81 ± 0.48 vs. 5.06 ± 0.66 ) and 14 days ( 2.03 ± 0.45 vs. 3.61 ± 0.63 ) after surgery, with statistical significances ( P < 0.05 ). There were statistically significant differences between the two groups in terms of time to complete weight bearing ( 7 ± 0.87 weeks vs. 8.82 ± 0.88 weeks) and time to return to work ( 8.69 ± 0.94 vs. 9.93 ± 0.88 weeks) ( P < 0.05 ). One month after surgery, the X-ray examination results of both groups showed recovery. The AR-based rehabilitation training system showed a good application effect and prospect in the postoperative structural and functional recovery of patients with knee joint injury.

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Early recovery of basic mobility under femoral nerve block after hip fracture surgery – A propensity score matched pilot study

Cited by 13 publications

References 33 publications

The Lateral Femoral Cutaneous and Over the Hip (LOH) Block for the Surgical Management of Hip Fractures: A Safe and Effective Anesthetic Strategy

The Lateral Femoral Cutaneous and Over the Hip (LOH) Block for the Surgical Management of Hip Fractures: A Safe and Effective Anesthetic Strategy

Peripheral Nerve Block Delays Mobility and Increases Length of Stay in Patients With Geriatric Hip Fracture

Effect of Remote Control Augmented Reality Multimedia Technology for Postoperative Rehabilitation of Knee Joint Injury

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