Muse Iyabo O, Deiling Brittany, Grinman Leon, Hadeed Michael M, Elkassabany Nabil
Department of Anesthesiology, University of Virginia Health System, Charlottesville, VA 22908, USA.
Department of Orthopedic Surgery, University of Virginia Health System, Charlottesville, VA 22903, USA.
J Clin Med. 2024 Jun 13;13(12):3457. doi: 10.3390/jcm13123457.
The incidence of hip fractures has continued to increase as life expectancy increases. Hip fracture is one of the leading causes of increased morbidity and mortality in the geriatric population. Early surgical treatment (<48 h) is often recommended to reduce morbidity/mortality. In addition, adequate pain management is crucial to optimize functional recovery and early mobilization. Pain management often consists of multimodal therapy which includes non-opioids, opioids, and regional anesthesia techniques. In this review, we describe the anatomical innervation of the hip joint and summarize the commonly used peripheral nerve blocks to provide pain relief for hip fractures. We also outline literature evidence that shows each block's efficacy in providing adequate pain relief. The recent discovery of a nerve block that may provide adequate sensory blockade of the posterior capsule of the hip is also described. Finally, we report a surgeon's perspective on nerve blocks for hip fractures.
随着预期寿命的增加，髋部骨折的发生率持续上升。髋部骨折是老年人群发病率和死亡率增加的主要原因之一。通常建议早期手术治疗（<48小时）以降低发病率/死亡率。此外，充分的疼痛管理对于优化功能恢复和早期活动至关重要。疼痛管理通常包括多模式治疗，其中包括非阿片类药物、阿片类药物和区域麻醉技术。在本综述中，我们描述了髋关节的解剖神经支配，并总结了常用的外周神经阻滞以缓解髋部骨折的疼痛。我们还概述了显示每种阻滞在提供充分疼痛缓解方面疗效的文献证据。还描述了最近发现的一种可能对髋关节后囊提供充分感觉阻滞的神经阻滞。最后，我们报告了外科医生对髋部骨折神经阻滞的看法。
