{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:35:59Z","timestamp":1786649759240,"version":"build-2736575974"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>No study has evaluated peripheral nerve block as the primary anesthetic technique in adult hip fracture surgery. This retrospective cohort study compares peri-operative outcomes between spinal anesthesia and peripheral nerve block with sedation (block-sedation) in adult emergency hip fracture surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Adult patients who underwent hip fracture repair at Fleury Hospital between 2018 and 2025 were screened (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 503). Of these, patients receiving planned spinal anesthesia (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 238) or block-sedation (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 230) were identified. Primary outcome was the success rate of block-sedation in emergency hip fracture surgery, defined as the proportion of patients in whom block-sedation was used without conversion to another anesthetic technique. Secondary outcomes included peri-operative opioid requirement (MME), postoperative pain, intra-operative anesthetic requirements (i.e., ketamine, midazolam, propofol), post-anesthesia care unit (PACU) stay, hospital length of stay, and intra-operative hypotension requiring inotropes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Block-sedation was successful without conversion in 98.1% of patients; four patients (1.9%) required conversion to general anesthesia and were excluded from peri-operative outcomes. Median PACU stay was longer in the spinal group (54 min, IQR 42\u201372) compared with block-sedation (36 min, IQR 27\u201353;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) The incidence of hypotension requiring inotropes was higher in the spinal group (53.0%) compared with the block-sedation group (19.4%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Postoperative pain scores were comparable between groups (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.126), and postoperative hospital length of stay was also similar (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.416).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In this propensity-matched cohort study, block-sedation was feasible and safe for MIS hip fracture surgeries, with a high success rate (&gt;98%) and low conversion to general anesthesia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/sja.sja_891_25","type":"journal-article","created":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T07:00:50Z","timestamp":1775199650000},"page":"332-338","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["A novel technique of peripheral nerve blocks and sedation as primary anesthetic technique for adult emergency hip fracture surgery: A retrospective propensity matched study"],"prefix":"10.4103","volume":"20","author":[{"given":"Angelina","family":"Low","sequence":"first","affiliation":[{"name":"Department of Surgical and Interventional Sciences, McGill University Health Centre, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Bettan","sequence":"additional","affiliation":[{"name":"Department of Surgical and Interventional Sciences, McGill University Health Centre, Montreal, QC, 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