{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:29:03Z","timestamp":1784939343443,"version":"3.55.0"},"reference-count":24,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100014103","name":"SGOfonds","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100014103","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients presenting in the emergency department (ED) with a hip fracture are often in significant pain. Opioids are frequently prescribed as part of standardized pain protocols, but are associated with many adverse events, especially in the elderly. Regional anaesthesia with a femoral nerve block (FNB), Fascia Iliaca compartment block (FICB) or Pericapsular nerve block (PENG) may provide a reasonable alternative to these patients. We designed a prospective multicentre study to compare the efficacy and safety of these blocks in the ED setting, which has been registered in the Centrale Commissie Mensgebonden Onderzoek (CCMO) Research Portal (NL-OMON57433).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>A multicentre Randomized Controlled Trial (RCT), conducted in the ED of 5 hospitals in the Netherlands. A total of 254 adult patients (18+) presenting to the ED with a neck of femur or pertrochanteric femur fracture will be randomised to receive FNB, FICB or PENG in the ED after informed consent has been obtained. Patients will be followed for 12 hours after block placement in the ED. The primary (patient reported) outcome measure is overall patient wellbeing 6\u20138 hours after block administration (or until operation, whichever comes first) as scored by the validated Quality of Recovery (QoR-15) questionnaire. Secondary outcome measures will be pre-operative pain scores, the cumulative dose of analgesics used during the first 12 hours after block placement or until operation, and complication rates for each of the blocks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Expected results<\/jats:title>\n                    <jats:p>This randomized controlled trial with a superiority design will allow conclusions on which regional nerve block is most effective in improving pre-operative wellbeing in patients with a neck of femur or pertrochanteric fracture. The choice to use a patient reported outcome measure to evaluate block efficacy maximizes clinical relevance. And by allowing the choice of local anaesthetic to the participating hospital (with a 1:1:1 randomization for each participating centre) clinical applicability of our findings is maximized.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0342422","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T18:23:24Z","timestamp":1770661404000},"page":"e0342422","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Protocol of a multi-centre randomized controlled trial to compare pericapsular nerve group block, fascia-iliaca compartment block and femoral nerve block for pain management in patients with a hip fracture in the emergency department (CPFF-ED)"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-8252-719X","authenticated-orcid":true,"given":"Jurian","family":"Dolstra","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0080-3642","authenticated-orcid":true,"given":"Svenja L.","family":"Haak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7928-5309","authenticated-orcid":true,"given":"E. Christiaan","family":"Boerma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heleen","family":"Lameijer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1462-6130","authenticated-orcid":true,"given":"Ewoud Ter","family":"Avest","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,2,9]]},"reference":[{"issue":"6","key":"pone.0342422.ref001","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1007\/BF01623184","article-title":"Hip fractures in the elderly: a world-wide projection","volume":"2","author":"C Cooper","year":"1992","journal-title":"Osteoporos Int"},{"key":"pone.0342422.ref002","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1002\/hec.3278","article-title":"European regional differences in all-cause mortality and length of stay for patients with hip fracture","author":"E Medin","year":"2015","journal-title":"Health Econ"},{"issue":"7","key":"pone.0342422.ref003","doi-asserted-by":"crossref","first-page":"1913","DOI":"10.1007\/s11999-010-1736-3","article-title":"Gender and race\/ethnicity differences in hip fracture incidence, morbidity, mortality, and function","volume":"469","author":"RS Sterling","year":"2011","journal-title":"Clin Orthop Relat Res"},{"issue":"6","key":"pone.0342422.ref004","doi-asserted-by":"crossref","first-page":"1336","DOI":"10.1097\/ALN.0000000000000478","article-title":"Perioperative management of elderly patients with hip fracture","volume":"121","author":"J Boddaert","year":"2014","journal-title":"Anesthesiology"},{"issue":"10","key":"pone.0342422.ref005","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1007\/s11916-019-0814-9","article-title":"A comprehensive review of analgesia and pain modalities in hip fracture pathogenesis","volume":"23","author":"A Dizdarevic","year":"2019","journal-title":"Curr Pain Headache Rep"},{"issue":"6","key":"pone.0342422.ref006","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1111\/acem.12154","article-title":"A comparison of ultrasound-guided three-in-one femoral nerve block versus parenteral opioids alone for analgesia in emergency department patients with hip fractures: a randomized controlled trial","volume":"20","author":"FL Beaudoin","year":"2013","journal-title":"Acad Emerg Med"},{"issue":"9","key":"pone.0342422.ref007","article-title":"Analgesic efficacy and adverse effects of epidural morphine compared to parenteral opioids after elective caesarean section: a systematic review","volume":"14","author":"M-P Bonnet","year":"2010","journal-title":"Eur J Pain"},{"key":"pone.0342422.ref008","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/S0735-6757(96)90123-0","article-title":"Age as a risk factor for inadequate emergency department analgesia","volume":"14","author":"JS Jones","year":"1996","journal-title":"Am J Emerg Med"},{"issue":"10208","key":"pone.0342422.ref009","doi-asserted-by":"crossref","first-page":"1560","DOI":"10.1016\/S0140-6736(19)32229-9","article-title":"Global patterns of opioid use and dependence: harms to populations, interventions, and future action","volume":"394","author":"L Degenhardt","year":"2019","journal-title":"Lancet"},{"key":"pone.0342422.ref010","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1046\/j.1532-5415.2003.51110.x","article-title":"Estimating hip fracture morbidity, mortality and costs","volume":"51","author":"RS Braithwaite","year":"2003","journal-title":"J Am Geriatr Soc"},{"issue":"3","key":"pone.0342422.ref011","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1007\/s12630-012-9880-8","article-title":"Efficacy of supplemental peripheral nerve blockade for hip fracture surgery: multiple treatment comparison","volume":"60","author":"S Rashiq","year":"2013","journal-title":"Can J Anaesth"},{"issue":"12","key":"pone.0342422.ref012","doi-asserted-by":"crossref","first-page":"2433","DOI":"10.1111\/jgs.14386","article-title":"Regional nerve blocks improve pain and functional outcomes in hip fracture: a randomized controlled trial","volume":"64","author":"RS Morrison","year":"2016","journal-title":"J Am Geriatr Soc"},{"issue":"3","key":"pone.0342422.ref013","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1097\/BOT.0000000000001035","article-title":"Impact of anesthesia on hospital mortality and morbidities in geriatric patients following emergency hip fracture surgery","volume":"32","author":"C Qiu","year":"2018","journal-title":"J Orthop Trauma"},{"issue":"2","key":"pone.0342422.ref014","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1111\/anae.15291","article-title":"Guideline for the management of hip fractures 2020: guideline by the association of anaesthetists","volume":"76","author":"R Griffiths","year":"2021","journal-title":"Anaesthesia"},{"key":"pone.0342422.ref015","unstructured":"Royal College of Emergency Medicine. Best practice guideline - management of pain in adults. 2021."},{"key":"pone.0342422.ref016","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.ajem.2025.06.009","article-title":"PENG, fascia-iliaca compartment block or femoral nerve block for pain management of patients with hip fractures","volume":"96","author":"J Dolstra","year":"2025","journal-title":"Am J Emerg Med"},{"issue":"6","key":"pone.0342422.ref017","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1016\/j.bja.2022.03.009","article-title":"Measurement of quality of recovery after surgery using the 15-item quality of recovery scale: a systematic review and meta-analysis","volume":"128","author":"PS Myles","year":"2022","journal-title":"Br J Anaesth"},{"issue":"1","key":"pone.0342422.ref018","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1186\/s12871-023-02245-3","article-title":"Effect of ultrasound-guided pericapsular nerve group (PENG) block on pain during patient positioning for central nervous blockade in hip surgery: a randomized controlled trial","volume":"23","author":"H Aygun","year":"2023","journal-title":"BMC Anesthesiol"},{"issue":"1","key":"pone.0342422.ref019","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1186\/s12877-023-03786-5","article-title":"Effect of perioperative ultrasound guided fascia iliaca compartment block in elderly adults with hip fractures undergoing arthroplasty in spinal anesthesia-a randomized controlled trial","volume":"23","author":"L Chen","year":"2023","journal-title":"BMC Geriatr"},{"key":"pone.0342422.ref020","author":"Nysora","year":"2020"},{"key":"pone.0342422.ref021","author":"Nysora","year":"2018"},{"key":"pone.0342422.ref022","author":"Nysora","year":"2018"},{"issue":"10","key":"pone.0342422.ref023","doi-asserted-by":"crossref","first-page":"913","DOI":"10.4103\/ija.ija_553_23","article-title":"Ultrasound-guided pericapsular nerve group (PENG) block versus femoral nerve block for positioning during spinal anaesthesia in proximal femur fractures: a randomised comparative study","volume":"67","author":"K Chaudhary","year":"2023","journal-title":"Indian J Anaesth"},{"issue":"3","key":"pone.0342422.ref024","first-page":"798","article-title":"Comparative study of ultrasound guided PENG [Pericapsular Nerve Group] block and FIB [Fascia Iliaca Block] for positioning and postoperative analgesia prior to spinal anaesthesia for hip surgeries: prospective randomized comparative clinical study","volume":"7","author":"K Shankar","year":"2020","journal-title":"Indian J Anesth Analg"}],"updated-by":[{"DOI":"10.1371\/journal.pone.0344680","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000}}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0342422","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T18:23:28Z","timestamp":1770661408000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0342422"}},"subtitle":[],"editor":[{"given":"Ismail Tawfeek Abdelaziz","family":"Badr","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,2,9]]},"references-count":24,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2,9]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0342422","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,9]]}}}