FICB for Hip Fracture Pain in Elderly

The QoR-15 score was used to evaluate the effect of early intervention with liposomal bupivacaine for fascia iliaca compartment block on improving the 24-hour postoperative quality of recovery in patients undergoing hip fracture surgery.

QoR-15 score used to evaluate the effect of early intervention with liposomal bupivacaine for fascia iliaca compartment block on improving 48-hour postoperative quality of recovery in patients undergoing hip fracture surgery.

Pain intensity will be assessed using the Numerical Rating Scale (NRS), ranging from 0 (no pain) to 10 (worst possible pain). Higher scores indicate worse pain. Assessments will be performed at the following time points: (1) daily from hospital admission until the day before surgery (up to 7 days); (2) immediately upon arrival in the operating room (pre-surgery); and (3) at 24 hours (Day 1), 48 hours (Day 2), and 72 hours (Day 3) post-surgery.

Total opioid consumption will be recorded from hospital admission to hospital discharge. All opioid doses will be converted to intravenous morphine milligram equivalents (MMEs) for standardization and summed for each patient.

Total consumption of non-opioid analgesics, including acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), and other rescue analgesics, will be recorded from hospital admission to hospital discharge. All doses will be documented and summed for each patient.

Total sleep time in hours per 24-hour period, documented by patient diary. Sleep duration will be recorded daily from admission until the day before surgery, and at 24 hours, 48 hours, and 72 hours post-surgery.

Sleep quality will be assessed using the Pittsburgh Sleep Quality Index (PSQI), a validated self-rated questionnaire. The global PSQI score ranges from 0 to 21, with higher scores indicating worse sleep quality (a global score >5 indicates poor sleep quality). PSQI will be measured at the following time points: daily from admission until the day before surgery; and 24 hours, 48 hours, and 72 hours post-surgery.

Extubation time is defined as the time from the end of surgery to tracheal extubation.

Emergence agitation (EA) is defined as a state of agitation, confusion, disorientation, and/or hyperactivity during the transition from unconsciousness to full wakefulness in the post-anesthesia care unit (PACU). The incidence of EA will be recorded as the proportion of patients who develop EA during the PACU stay.

Postoperative delirium (POD) will be assessed daily from the end of surgery until hospital discharge. Delirium will be diagnosed using the 3-Minute Diagnostic Interview for Confusion Assessment Method (3D-CAM) for non-ICU patients or the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) for patients requiring intensive care. Both tools are validated versions of the original CAM algorithm. The diagnosis of delirium requires: (1) acute onset or fluctuating course, (2) inattention, and (3) either disorganized thinking or altered level of consciousness. The incidence of POD will be reported as the proportion of patients who experience at least one episode of delirium during the postoperative hospitalization period.

Length of hospital stay is defined as the total number of days from hospital admission to hospital discharge.

Overall satisfaction with pain management will be assessed at hospital discharge using a validated satisfaction scale. Degree of patient satisfaction will be assessed on a 5-point Likert scale (1=extremely dissatisfied, 2=unsatisfied, 3=neutral, 4=satisfied, 5=extremely satisfied).