Femoral Nerve Catheters Improve Home Disposition and Pain in Hip Fracture Patients Treated With Total Hip Arthroplasty

Abstract Background Opioids have been the mainstay of treatment in the physiologically young geriatric hip fracture patient undergoing total hip arthroplasty (THA). However opioid-related side effects increase morbidity. Regional anesthesia may provide better analgesia, while decreasing opioid-related side effects. The goal of this study was to examine the effect of perioperative continuous femoral nerve blockade with regards to pain scores, opioid-related side effects and post-hospital disposition in hip fracture patients undergoing THA. Methods 29 consecutive geriatric hip fracture patients (22 females/7 males) underwent THA. Average follow up was 8.3 months (6 weeks - 39 months). 15 patients were treated with standard analgesia (SA). 14 patients received an ultrasound-guided insertion of a femoral nerve catheter (CFNC) after radiographic confirmation of a hip fracture. All complications and re-admissions that occurred within 6 weeks of surgery were noted. Results CFNC patients were discharged home more frequently than SA patients (43% for CFNC versus 7% for SA; p=0.023). CFNC patients reported lower average pain scores preoperatively (p