Ultrasound-Guided Regional Anesthesia by Emergency Physicians for Hip Fractures and Delirium: A Randomized Clinical Trial
Primary result · Delirium incidenceResult — go to the resultOdds ratio 0.72 95% CI 0.57–0.93Authors' conclusion
In this study, a knowledge-to-practice intervention improved nerve block uptake, and nerve blocks were quick, safe, and mostly effective.
Study context
- Population
- Patients aged ≥65 years with hip fracture not delirious on emergency department (ED) arrival; ED physicians not regularly performing point-of-care ultrasound-guided regional anesthesia (POCUS-GRA)208 ED physicians trained
- Participants
- 694 patients
- Comparison
- Knowledge-to-practice intervention vs before training
- Controln = 248reference
- Interventionn = 446
- Primary endpoint
- Incidence of delirium (Confusion Assessment Method) and duration of delirium in days
- Follow-up
- Within 7 days of ED presentation
Methodological detailscluster randomized, multicentre (7 academic EDs, 4 provinces, Canada)
- Cluster randomized
- Multicentre (7 academic EDs, 4 provinces, Canada)
Primary result
Delirium incidence
Odds ratio
0.72
95% CI 0.57–0.93
Intervention vs Control
OR 0.72 (95% CI 0.57–0.93)
As reported in the abstract
Further findings
Nerve block uptake
change 51.7%
- Nerve block uptake: control denominator 264 as printed
Block effectiveness (≥50% pain reduction)
- Effective blocks among 186 with pain data
- 107 [57.5%]
Procedure time
- Median [IQR] time, minutes
- 15 [12-20]
- Blocks <25 minutes
- 113 [90.0%]
Safety
Block complications
- Minor hematoma
- 1
Original publication
Ultrasound-Guided Regional Anesthesia by Emergency Physicians for Hip Fractures and Delirium: A Randomized Clinical Trial. JAMA Netw Open. Published 1 December 2025. doi:10.
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