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ASSESSING THE FEASIBILITY OF ULTRASOUND GUIDED FEMORAL NERVE BLOCKADE ADMINISTERED BY ORTHOPAEDIC TRAINEES FOR FRACTURED FEMURS IN THE EMERGENCY DEPARTMENT



Abstract

Study Objective: To determine the feasibility of ultrasound-guided femoral nerve blockade performed by orthopaedic trainees.

Methods: This was a prospective study involving patients presenting to Acciedent & Emergency with fractured femurs requiring analgesia. Physicians performing the nerve blocks were orthopaedic trainees who had participated in a 1-hour training session. The participants underwent ultrasonography-guided femoral nerve blocks to provide analgesia. Any additional analgesia required was recorded. Subjects rated their pain on a Numerical Pain Rating Scale (NRS) before the nerve block and 30 & 60minutes after the nerve block. The primary outcomes for feasibility were the requirement for additional analgesia following injection and the median reduction in pain on the Numerical Pain Rating Scale after the nerve block. Secondary outcomes for feasibility included the median time for completion of the entire nerve block procedure for each subject (from initiation of ultrasonography to completion of the last injection) and the percentage of participants wishing to have the same procedure for similar injuries in the future. Other secondary outcomes included the percentage of participants with complications during the procedure including nerve and vascular injection.

Results: All procedures (100%) were completed without additional anesthesia or analgesia with significant reduction in Numerical Pain Rating Scale. There were no immediate complications

Conclusion: Orthopaedic trainees can perform ultrasound-guided femoral nerve blocks in the emergency department with high patient satisfaction, after minimal training.


Correspondence should be sent to Mr Omar Abouazza, University of Limerick, Orthopaedics, Limerick, Ireland. omar.abouazza@gmail.com

The abstracts were prepared by Mr Matt Costa and Mr Ben Ollivere. Correspondence should be addressed to Mr Costa at Clinical Sciences Research Institute, University of Warwick, Clifford Bridge Road, Coventry CV2 2DX, UK.