Case study: Managing patients with fractured hips

300,000+ people sustain a hip fracture annually in the U.S. alone. Most of these fractures occur in patients 65 years of age or older and require surgical treatment within 1 to 2 days of injury. Read on to find out how we approach these cases at our headquarters and see how it compares to your practice.

All patients presenting with a hip fracture receive:

• Suprainguinal fascia iliaca block with 25-30 mL of 0.25% bupivacaine for analgesia for positioning for spinal anesthesia and postoperative pain Rx. We wait 10 minutes for the block to set in

Suprainguinal fascia iliaca block

• Spinal anesthesia with 2 mL of 0.5% isobaric bupivacaine via the paramedian approach. Hip fracture patients are typically older, with osteophytes, ossified ligaments, and spine deformities, making the paramedian approach in the lateral position the best technique, in our opinion

Spinal anesthesia with the paramedian approach in the lateral position

• Most patients receive 5 mg ketamine + 1 mg midazolam for premedication and 20 mg propofol for positioning the patient in the lateral position for spinal anesthesia

For more case studies like these and the complete guide to the 60 most frequently used nerve blocks, download the Nerve Blocks App HERE.