naa a22 4500 510743560 CHVBK 20180411083037.0 cr unu---uuuuu 180411e20130301xx s 000 0 eng 10.1007/s12630-012-9880-8 doi (NATIONALLICENCE)springer-10.1007/s12630-012-9880-8 Efficacy of supplemental peripheral nerve blockade for hip fracture surgery: multiple treatment comparison [Elektronische Daten] [Saifee Rashiq, Ben Vandermeer, Ahmed Abou-Setta, Lauren Beaupre, C. Jones, Donna Dryden] Efficacité d'un bloc nerveux périphérique supplémentaire pour les chirurgies de fracture de la hanche: Comparaison de plusieurs traitements Purpose: This study was designed to determine the most effective peripheral nerve block supplement to standard anesthesia management for hip fracture patients. Methods: We systematically reviewed randomized controlled trials (RCTs) published from 1990 to 2010 and conducted multiple treatment comparisons using direct and indirect evidence for two outcomes, i.e., acute pain intensity and delirium. We combined trials by type of injection (regardless of time of insertion during the perioperative phase, use of nerve block catheter, local anesthetic type, additives, or duration of treatment). Results: Twenty-one RCTs comprising 1,422 participants were included. In most cases, the trials were conducted in Europe; they excluded patients with cognitive impairment, and they were unclear or at high risk of bias. The combination of obturator and lateral femoral cutaneous nerve blockade had the highest probability of being the most effective against acute postoperative pain. Fascia iliaca blockade had the highest probability of being the most effective against delirium. There was no difference in outcomes among other nerve blocks. Conclusion: Not all nerve blocks are equally effective in improving outcomes after hip fracture. Multiple treatment comparison, a tool to compare the effectiveness of multiple treatments simultaneously, provides useful guidance to anesthesia providers seeking effective treatment when faced with a body of RCTs wherein each investigates one treatment. More RCTs comparing multiple nerve blocks in hip fracture are needed. Canadian Anesthesiologists' Society, 2013 Rashiq Saifee Division of Pain Medicine, Department of Anesthesiology and Pain Medicine, Faculty of Medicine and Dentistry, University of Alberta, 8-120Clinical Sciences Building, T6G 2G3, Edmonton, AB, Canada aut Vandermeer Ben University of Alberta Evidence-based Practice Center, Edmonton, AB, Canada aut Abou-Setta Ahmed George & Fay Yee Centre for Healthcare Innovation, University of Manitoba/Winnipeg Regional Health Authority, Winnipeg, MB, Canada aut Beaupre Lauren Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada aut Jones C. Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada aut Dryden Donna University of Alberta Evidence-based Practice Center, Edmonton, AB, Canada aut Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer-Verlag 60/3(2013-03-01), 230-243 0832-610X 60:3<230 2013 60 12630 https://doi.org/10.1007/s12630-012-9880-8 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12630-012-9880-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Rashiq Saifee Division of Pain Medicine, Department of Anesthesiology and Pain Medicine, Faculty of Medicine and Dentistry, University of Alberta, 8-120Clinical Sciences Building, T6G 2G3, Edmonton, AB, Canada aut NATIONALLICENCE 700 1- Vandermeer Ben University of Alberta Evidence-based Practice Center, Edmonton, AB, Canada aut NATIONALLICENCE 700 1- Abou-Setta Ahmed George & Fay Yee Centre for Healthcare Innovation, University of Manitoba/Winnipeg Regional Health Authority, Winnipeg, MB, Canada aut NATIONALLICENCE 700 1- Beaupre Lauren Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada aut NATIONALLICENCE 700 1- Jones C. Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada aut NATIONALLICENCE 700 1- Dryden Donna University of Alberta Evidence-based Practice Center, Edmonton, AB, Canada aut NATIONALLICENCE 773 0- Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer-Verlag 60/3(2013-03-01), 230-243 0832-610X 60:3<230 2013 60 12630 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer