A Dose Finding Study for Pain Relief of a Broken Hip
Status:
Unknown status
Trial end date:
2011-04-01
Target enrollment:
Participant gender:
Summary
Studies have suggested a link with effective pain relief and reduced illness and death in
high risk patients. Ultrasound guided nerve blocks have been associated with an increased
success rate and allow visualization of all the anatomical structures and the distribution of
the local anesthetic on injection. The hospital mortality for patients admitted to hospital
from home in the UK in 2006 with a fractured hip is 14.3% (Bottle and Aylin 947-51).
The aim of this clinical trial is to determine the effective dose of local anesthetic to
provide pain relief to patients with a broken hip using ultrasound to guide needle insertion.
The hospital mortality for patients admitted to hospital from home in the UK in 2006 with a
fractured hip was 14.3%. Patients for emergency surgical fixation or replacement of broken
hip will be recruited prior to surgical fixation. All patients recruited to this study will
receive standard anesthesia and surgical fixation of their broken hip.
The trial can be divided into two sequential parts; the results of part A will be an amount
of local anesthetic which will relieve pain of a broken hip in 95% of all patients. Part B
will determine the duration of pain relief provided by the amount of local anaesthetic from
part A and blood levels of local anesthetic.
In parts A and B a standard pain relieving nerve block to numb the nerves supplying the hip
joint will be administered using ultrasound to guide the injection of local anesthetic. The
patient will then be observed for 30 minutes during which time the feeling in the upper leg
and pain scores will be recorded. Patients with ineffective nerve blocks will be given
immediate pain relief and withdrawn from further participation in the study.
In part A the amount of local anesthetic for the next patient will be increased or decreased
if the nerve block is ineffective or effective respectively.
In part B the dose will be the same (calculated from the results of part A). In order to
determine the duration of pain relief pain scores will be recorded hourly for up to 24 hours.
Blood samples will be taken before the pain relieving nerve block and at 5, 10, 20, 30 and 60
minutes afterwards.