Ultrasound Guided Femoral Nerve Block

In this proposed protocol the investigators will conduct a prospective, randomized control
trial comparing the efficacy of Ultrasound Guided Femoral Nerve Blockade (USFNB) versus the
standard of care pain management by parenteral injection of opioid pain medication of
patients presenting with hip fracture at the BIDMC ED. We hypothesize that USNFB approach
will be non-inferior in achieving pain control (efficacy) and superior in the total dose of
opioids (lower amount) as compared to the standard protocol. The enrolled population will be
randomized 1:1 using a simple balanced randomization scheme.

Participants will be surveyed six times 6 times on a Visual Analog Scale (VAS)* on their pain
intensity reduction over 4 hours.

Physicians performing the block will be surveyed promptly following the procedure regarding
difficulty performing the block and its efficacy.

Specific Aim #1: The investigators hypothesize that in patients presenting to the ED with hip
fracture, USFNB will demonstrate equal efficacy in pain relief with fewer side effects when
compared to conventional parenteral opioid therapy. The investigators evaluate this
hypothesis by monitoring Visual Analogue Scales (VAS) in patients receiving either USGFNB or
opioid therapy over the first 4 hours of observation. The side effects will be noted during
the same interval of time.

Specific Aim #2: The investigators hypothesize that in patients presenting to the ED with hip
fracture, USFNB will reduce the amount of narcotic used to control pain. The investigators
will evaluate this by studying narcotic use over the first 4 hours of evaluation.

Inclusion Criteria:

- Patients over 18 years of age presenting to the ED with radiographically established
intra-, extracapsular hip fracture, able to consent and participate in the study and
who have moderate to severe pain (numerical pain score >= 31) at the time of
enrollment.

Exclusion Criteria:

- Patients with a previous history of hypersensitivity to local anesthetics,

- Patients who have signs of a local infection at the site of planned needle placement.