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Regional Nerve Block Decreases the Incidence of Postoperative Delirium in Elderly Hip Fracture

Postoperative delirium is common in elderly patients with hip fracture. Pain is a major risk factor for delirium, and regional nerve blocks (RNBs) effectively control pain in hip fractures. This study aimed to evaluate the effect of RNB on delirium after hip surgery in elderly patients. This retrosp...

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Autores principales: Lim, Eic Ju, Koh, Won Uk, Kim, Hyungtae, Kim, Ha-Jung, Shon, Hyun-Chul, Kim, Ji Wan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8397073/
https://www.ncbi.nlm.nih.gov/pubmed/34441882
http://dx.doi.org/10.3390/jcm10163586
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author Lim, Eic Ju
Koh, Won Uk
Kim, Hyungtae
Kim, Ha-Jung
Shon, Hyun-Chul
Kim, Ji Wan
author_facet Lim, Eic Ju
Koh, Won Uk
Kim, Hyungtae
Kim, Ha-Jung
Shon, Hyun-Chul
Kim, Ji Wan
author_sort Lim, Eic Ju
collection PubMed
description Postoperative delirium is common in elderly patients with hip fracture. Pain is a major risk factor for delirium, and regional nerve blocks (RNBs) effectively control pain in hip fractures. This study aimed to evaluate the effect of RNB on delirium after hip surgery in elderly patients. This retrospective comparative study was performed in a single institution, and the data were collected from medical records between March 2018 and April 2021. Patients aged ≥60 years who underwent proximal femoral fracture surgery were included, while those with previous psychiatric illness and cognitive impairment were excluded. Two hundred and fifty-two patients were enrolled and divided into an RNB or a control group according to RNB use. Delirium was assessed as the primary outcome and postoperative pain score, pain medication consumption, and rehabilitation assessment as the secondary outcomes. Between the RNB (n = 129) and control groups (n = 123), there was no significant difference in the baseline characteristics. The overall incidence of delirium was 21%; the rate was lower in the RNB group than in the control group (15 vs. 27%, respectively, p = 0.027). The average pain score at 6 h postoperatively was lower in the RNB group than in the control group (2.8 ± 1.5 vs. 3.3 ± 1.6, respectively, p = 0.030). There was no significant difference in the pain score at 12, 24, and 48 h postoperatively, amount of opioids consumed for 2 postoperative days, and time from injury to wheelchair ambulation. We recommend RNB as a standard procedure for elderly patients with hip fracture due to lower delirium incidence and more effective analgesia in the early postoperative period.
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spelling pubmed-83970732021-08-28 Regional Nerve Block Decreases the Incidence of Postoperative Delirium in Elderly Hip Fracture Lim, Eic Ju Koh, Won Uk Kim, Hyungtae Kim, Ha-Jung Shon, Hyun-Chul Kim, Ji Wan J Clin Med Article Postoperative delirium is common in elderly patients with hip fracture. Pain is a major risk factor for delirium, and regional nerve blocks (RNBs) effectively control pain in hip fractures. This study aimed to evaluate the effect of RNB on delirium after hip surgery in elderly patients. This retrospective comparative study was performed in a single institution, and the data were collected from medical records between March 2018 and April 2021. Patients aged ≥60 years who underwent proximal femoral fracture surgery were included, while those with previous psychiatric illness and cognitive impairment were excluded. Two hundred and fifty-two patients were enrolled and divided into an RNB or a control group according to RNB use. Delirium was assessed as the primary outcome and postoperative pain score, pain medication consumption, and rehabilitation assessment as the secondary outcomes. Between the RNB (n = 129) and control groups (n = 123), there was no significant difference in the baseline characteristics. The overall incidence of delirium was 21%; the rate was lower in the RNB group than in the control group (15 vs. 27%, respectively, p = 0.027). The average pain score at 6 h postoperatively was lower in the RNB group than in the control group (2.8 ± 1.5 vs. 3.3 ± 1.6, respectively, p = 0.030). There was no significant difference in the pain score at 12, 24, and 48 h postoperatively, amount of opioids consumed for 2 postoperative days, and time from injury to wheelchair ambulation. We recommend RNB as a standard procedure for elderly patients with hip fracture due to lower delirium incidence and more effective analgesia in the early postoperative period. MDPI 2021-08-15 /pmc/articles/PMC8397073/ /pubmed/34441882 http://dx.doi.org/10.3390/jcm10163586 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lim, Eic Ju
Koh, Won Uk
Kim, Hyungtae
Kim, Ha-Jung
Shon, Hyun-Chul
Kim, Ji Wan
Regional Nerve Block Decreases the Incidence of Postoperative Delirium in Elderly Hip Fracture
title Regional Nerve Block Decreases the Incidence of Postoperative Delirium in Elderly Hip Fracture
title_full Regional Nerve Block Decreases the Incidence of Postoperative Delirium in Elderly Hip Fracture
title_fullStr Regional Nerve Block Decreases the Incidence of Postoperative Delirium in Elderly Hip Fracture
title_full_unstemmed Regional Nerve Block Decreases the Incidence of Postoperative Delirium in Elderly Hip Fracture
title_short Regional Nerve Block Decreases the Incidence of Postoperative Delirium in Elderly Hip Fracture
title_sort regional nerve block decreases the incidence of postoperative delirium in elderly hip fracture
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8397073/
https://www.ncbi.nlm.nih.gov/pubmed/34441882
http://dx.doi.org/10.3390/jcm10163586
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