Regional Nerve Blocks For Hip and XXXX in the Emergency Department: A Systematic Review.

@entity1 @entity2249 @entity158 @entity1443 @entity616
OBJECTIVES: Hip and @entity2249 are common in elderly @entity1 , who are at an increased risk of complications if their @entity158 is suboptimally managed. This systematic review seeks to determine if regional nerve blocks reduce @entity158 , reduce the need for parenteral opiates, and reduce complications, compared to @entity158 management with opiates, @entity1443 , or NSAIDs. Data sources Systematic review of MEDLINE, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials found 401 articles, of which nine were selected for inclusion. Study selection Randomized controlled trials including adult @entity1 with a hip or @entity2249 (Population) who had a 3-in-1 femoral nerve @entity616 , or fascia iliaca compartment block performed preoperatively (Intervention). Comparison must have been made with @entity158 management with opiates, @entity1443 , or NSAIDs (Comparison) and outcomes must have included @entity158 score reduction (Outcome). Data synthesis Eight out of nine studies concluded @entity158 scores were improved with the regional nerve block compared to @entity158 management. A significant reduction in parenteral opiate use was seen in five out of six studies. No @entity1 suffered life-threatening complications related to the nerve block; however, more minor complications were under-reported. Most of the studies were at a moderate to high risk of bias. CONCLUSIONS: Regional nerve blocks for hip and @entity2249 have a benefit in reducing @entity158 and the need for IV opiates. The use of these blocks can be recommended for these @entity1 . Further high-quality randomized controlled trials are required.
