{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T17:42:16Z","timestamp":1783618936984,"version":"3.55.0"},"reference-count":18,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Emerg Med J"],"accepted":{"date-parts":[[2014,11,10]]},"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Femoral neck fractures are a common and painful injury. Femoral nerve blocks, and a variant of this technique termed the \u20183-in-1\u2019 block, are often used in this patient group, but their effect is variable. The fascia iliaca compartment block (FIB) has been proposed as an alternative, but the relative effectiveness of the two techniques in the early stages of care is unknown. We therefore compared the FIB versus the 3-in-1 block in a randomised trial conducted in two UK emergency departments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Parallel, two-group randomised equivalence trial. Consenting patients &gt;18\u2005years with a femoral neck fracture were randomly allocated to receive either a FIB or a 3-in-1 block. The primary outcome was pain measured on a 100\u2005mm visual analogue scale at 60\u2005min. The between-group difference was adjusted for centre, age, sex, fracture type, pre-block analgesia and pre-block pain score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>178 patients were randomised and 162 included in the primary analysis. The mean 100\u2005mm visual analogue pain scale score at 60\u2005min was 38\u2005mm in the FIB arm and 35\u2005mm in the 3-in-1 arm. The adjusted difference between the arms was 3\u2005mm, with a 95% CI (\u22124.7 to 10.8) that excluded a clinically important difference between the two interventions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>FIB is equivalent to the 3-in-1 block for immediate pain relief in adult neck of femur fractures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration number<\/jats:title><jats:p>ISRCTN16152419.<\/jats:p><\/jats:sec>","DOI":"10.1136\/emermed-2013-203407","type":"journal-article","created":{"date-parts":[[2014,11,28]],"date-time":"2014-11-28T15:39:08Z","timestamp":1417189148000},"page":"685-689","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":47,"title":["Randomised trial of the fascia iliaca block versus the \u20183-in-1\u2019 block for femoral neck fractures in the emergency department"],"prefix":"10.1136","volume":"32","clinical-trial-number":[{"clinical-trial-number":"isrctn16152419","registry":"10.18810\/isrctn"}],"author":[{"given":"Paul","family":"Reavley","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan A","family":"Montgomery","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason E","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Binks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Edwards","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgina","family":"Elder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Benger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2014,11,27]]},"reference":[{"key":"2024052700541834000_32.9.685.1","unstructured":"National Institute for Health and Care Excellence. Clinical Guideline 124 Hip Fracture: the management of hip fracture in adults. London: NICE, 2011. http:\/\/guidance.nice.org.uk\/CG124 (accessed 11\/10\/13)."},{"key":"2024052700541834000_32.9.685.2","unstructured":"College of Emergency Medicine. Clinical Standards for Emergency Departments. London: CEM, 2013. http:\/\/www.collemergencymed.ac.uk\/Shop-Floor\/Clinical%20Standards\/default.asp (accessed 11-10-13)."},{"key":"2024052700541834000_32.9.685.3","first-page":"887","article-title":"Inadvertent \u20183 in 1\u2019 block following injection of the lateral cutaneous nerve of the thigh","volume":"59","author":"Sharrock","year":"1989","journal-title":"Anesth Analg"},{"key":"2024052700541834000_32.9.685.4","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1213\/00000539-197311000-00036","article-title":"The inguinal paravascular technique of lumbar plexus anaesthesia: The \u201c3-in-1\u201d block","volume":"52","author":"Winnie","year":"1973","journal-title":"Anesth Analg"},{"key":"2024052700541834000_32.9.685.5","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1111\/anae.12321","article-title":"A comparison of pre-operative nerve stimulator guided femoral nerve block and fascia iliaca compartment block in patients with a femoral neck fracture","volume":"69","author":"Newman","year":"2013","journal-title":"Anaesthesia"},{"key":"2024052700541834000_32.9.685.6","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1002\/cpt1974155443","article-title":"Minimization: a new method of assigning subjects to treatment and control groups","volume":"15","author":"Taves","year":"1974","journal-title":"Clin Pharmacol Therapeut"},{"key":"2024052700541834000_32.9.685.7","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(96)70238-X"},{"key":"2024052700541834000_32.9.685.8","doi-asserted-by":"publisher","DOI":"10.1136\/emermed-2013-202794"},{"key":"2024052700541834000_32.9.685.9","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/58.1.M76"},{"key":"2024052700541834000_32.9.685.10","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2000.tb04718.x"},{"key":"2024052700541834000_32.9.685.11","doi-asserted-by":"publisher","DOI":"10.1136\/emj.2010.104687"},{"key":"2024052700541834000_32.9.685.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2006.08.011"},{"key":"2024052700541834000_32.9.685.13","doi-asserted-by":"publisher","DOI":"10.1097\/00115550-200611000-00017"},{"key":"2024052700541834000_32.9.685.14","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200103000-00029"},{"key":"2024052700541834000_32.9.685.15","first-page":"140","article-title":"Accidental badder puncture: a complication of modified fascia iliaca block","volume":"37","author":"Blackford","year":"2009","journal-title":"Anaesth Intensive Care"},{"key":"2024052700541834000_32.9.685.16","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000258740.17193.ec"},{"key":"2024052700541834000_32.9.685.17","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200211000-00034"},{"key":"2024052700541834000_32.9.685.18","doi-asserted-by":"publisher","DOI":"10.1136\/emermed-2012-201546"}],"container-title":["Emergency Medicine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/emermed-2013-203407","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T07:54:36Z","timestamp":1716796476000},"score":1,"resource":{"primary":{"URL":"https:\/\/emj.bmj.com\/lookup\/doi\/10.1136\/emermed-2013-203407"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,11,27]]},"references-count":18,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2015,8,20]]},"published-print":{"date-parts":[[2015,9]]}},"alternative-id":["10.1136\/emermed-2013-203407"],"URL":"https:\/\/doi.org\/10.1136\/emermed-2013-203407","relation":{},"ISSN":["1472-0205","1472-0213"],"issn-type":[{"value":"1472-0205","type":"print"},{"value":"1472-0213","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,11,27]]}}}