Use of Injectable Local Anesthetics Up for Hip Fracture

Increasing use of injected local anesthetics may represent move away from opioid analgesia for hip fracture patients

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MONDAY, March 28, 2022 (HealthDay News) -- The use of injectable local anesthetics on the day of presentation increased among hip fracture patients from 2009 to 2019, according to a study to be presented at the Annual Regional Anesthesiology and Acute Pain Medicine Meeting, being held from March 31 to April 2 in Las Vegas.

Alexander Stone, M.D., from the Hospital for Special Surgery in New York City, and colleagues assessed trends in injected local anesthetic utilization for hip fracture patients on the day of hospital presentation using data from the Premier Healthcare database (2009 to 2019). The analysis included 864,416 patients with an emergency admission (1,012 hospitals) due to a hip fracture.

The researchers found that the rate of use on the day of admission increased for lidocaine (from 28.4 percent in 2009 to 41.0 percent in 2019), as well as for bupivacaine (13.3 to 18.6 percent), ropivacaine (2.0 to 8.4 percent), and mepivacaine (0.05 to 0.14 percent). There was substantial between-hospital variation observed in local anesthetic use in these patients (interquartile range for any local anesthetic use, 19.8 to 60.2 percent). Only 0.11 percent of patients underwent surgery on the day of hospital presentation.

"This pattern could represent increased adoption of opioid-sparing techniques," the authors write. "The use of longer acting local anesthetics, specifically ropivacaine and bupivacaine, suggests that there is likely a trend towards sustained pain treatment being initiated early in admissions."

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