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Introduction <p>Peripheral nerve blocks (PNBs) have emerged as a promising pain management strategy for older adults undergoing hip fracture surgery. This study aimed to identify factors influencing PNB use and assess opinions on their effectiveness and implementation among physician anesthesiologists, certified registered nurse anesthetists (CRNAs), and certified anesthesiologist assistants (CAAs).</p> Methods <p>A cross-sectional study surveyed physician anesthesiologists, CRNAs, and CAAs caring for adults aged 50&#xa0;years and older with hip fractures from May 2024 to July 2024. The 22-item questionnaire explored demographics, PNB practices, perceived advantages, disadvantages, barriers to use, and interest in future research.</p> Results <p>A total of 185 surveys were returned: 94.5% from physician anesthesiologists, 4.9% from CRNAs, and 0.5% from a CAA. While 86% of respondents perceived PNBs as beneficial, 14% reported they were unsure or opposed the use of PNB for older adults undergoing surgical fixation of hip fractures. The reported primary perceived advantages of using PNB in older adults with hip fractures included reduced pain and decreased opioid use within 72&#xa0;h postoperatively. The reported primary difficulties in using PNB included surgical delays and institutional culture against PNB use. Most respondents (86%) supported further research on PNB outcomes to assess if benefits beyond acute pain exist.</p> Conclusion <p>The majority of anesthesia clinicians surveyed perceived PNBs as potentially beneficial for pain management in hip fracture patients. However, numerous reported barriers to PNB use were identified. Given the convenience sampling approach, these findings should be considered hypothesis-generating and further research on PNB's association with patient-centered outcomes and implementation strategies may help address these obstacles.</p>

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Anesthesia clinicians’ perspectives on peripheral nerve blocks for hip fractures in older adults

  • 期刊论文

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  • 发表日期：

    2026年2月18日

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  • Arissa M. Torrie,
  • Mark D. Neuman,
  • Sheila Sprague,
  • Flavia K. Borges,
  • Mary Scott-Herring,
  • Kellie Jaremko,
  • Ron E. Samet,
  • Francesca Mulazzani,
  • Nathan N. O’Hara,
  • Gerard P. Slobogean,
  • Kyle S. Ahn,
  • John C. Alexander,
  • Ravi Anandampillai,
  • Pilar Rubio Babiano,
  • Subha Brata Bagchi,
  • Shawn E. Banks,
  • M. Bardají-Carrillo,
  • Thomas Baribeault,
  • Artin Bastani,
  • Bonjo Batoon,
  • David Sanz Bedate,
  • Ramola Bhambhani,
  • Raquel Iglesias Blanco,
  • Diego Palenzuela Blasco,
  • Jason C. Brookman,
  • Katherine A. Bupp,
  • Rocío Gutiérrez Bustillo,
  • Jose Caldentey,
  • M. Cardozo-Panof,
  • Gulraj Chawla,
  • Clayton Cheney,
  • Gloria S. Cheng,
  • Laura E. W. Chin,
  • William Clark,
  • Bianca Conti,
  • A. Courtney,
  • Sara Cocho Crespo,
  • Jordanna Almeida Cristo-Barbosa,
  • Guillermo Sarmentero-López de Quintana,
  • Henrique Doria de Vasconcellos,
  • Matthias Desmet,
  • Derek Dillane,
  • Nicolas Dorsey,
  • Angel Fernández-Collantes,
  • Irina Gasanova,
  • María García Gento,
  • Brent D. Gerlach,
  • Carlota Gordaliza,
  • Veena Graff,
  • Lisa Gu,
  • Yuqi Gu,
  • Shannon Hagan,
  • Steven Hedgecorth,
  • Henar Muñoz Hernandez,
  • Michael Herrick,
  • Mark Hoeft,
  • HM Marie ,
  • Rita Rodríguez Jiménez,
  • Rebecca L. Johnson,
  • Justin Jones,
  • Jeremy Kaplowitz,
  • Michael Kerr,
  • James K. Kim,
  • Blanca O. Lea,
  • David A. Leon,
  • Jinlei Li,
  • Julie M. Marshall,
  • Al May,
  • Daniel I. McIsaac,
  • Lidia Mora Miquel,
  • Ludmil Mitrev,
  • Iain Moppett,
  • Ruiz Lopez Nuria,
  • Jason B. Ochroch,
  • Ignacio Puig Ortega,
  • M. T. Peláez-Jareño,
  • Daniel Perez,
  • Steven B. Porter,
  • Rodrigo Poves-Álvarez,
  • Christopher Prabhakar,
  • David Price,
  • Brandon Pruett,
  • Ramin Rahimian,
  • Reva Ramlogan,
  • Sripad Rao,
  • Hassan Rayaz,
  • Justin E. Richards,
  • Peter Rock,
  • Beatriz Francisco Sánchez,
  • Eric S. Schwenk,
  • Kara Segna,
  • Sudipta Sen,
  • Elena Carrasco Serrano,
  • Danial Shams,
  • Balram Sharma,
  • Harry C. Sherman,
  • Frederick E. Sieber,
  • John Sours,
  • Nicholas Statzer,
  • Raymond Tang,
  • Samir I. Thaker,
  • Andrew Tran,
  • Erin Treacy,
  • Kathleen Tyson,
  • Ana F. Urbón,
  • Luis F. Valdés-Vilches,
  • Joseph Villaluz,
  • David Velasco Villanueva,
  • Kamen Vlassakov,
  • Marlou Vogel,
  • William Warren,
  • Yvette Fouche Weber,
  • J. Alex Wharton,
  • John W. Wolfe,
  • Jeremy Wong,
  • Jonathan P. Wright,
  • Yar Luan Yeap,
  • Alex Zyernov

摘要

Introduction

Peripheral nerve blocks (PNBs) have emerged as a promising pain management strategy for older adults undergoing hip fracture surgery. This study aimed to identify factors influencing PNB use and assess opinions on their effectiveness and implementation among physician anesthesiologists, certified registered nurse anesthetists (CRNAs), and certified anesthesiologist assistants (CAAs).

Methods

A cross-sectional study surveyed physician anesthesiologists, CRNAs, and CAAs caring for adults aged 50 years and older with hip fractures from May 2024 to July 2024. The 22-item questionnaire explored demographics, PNB practices, perceived advantages, disadvantages, barriers to use, and interest in future research.

Results

A total of 185 surveys were returned: 94.5% from physician anesthesiologists, 4.9% from CRNAs, and 0.5% from a CAA. While 86% of respondents perceived PNBs as beneficial, 14% reported they were unsure or opposed the use of PNB for older adults undergoing surgical fixation of hip fractures. The reported primary perceived advantages of using PNB in older adults with hip fractures included reduced pain and decreased opioid use within 72 h postoperatively. The reported primary difficulties in using PNB included surgical delays and institutional culture against PNB use. Most respondents (86%) supported further research on PNB outcomes to assess if benefits beyond acute pain exist.

Conclusion

The majority of anesthesia clinicians surveyed perceived PNBs as potentially beneficial for pain management in hip fracture patients. However, numerous reported barriers to PNB use were identified. Given the convenience sampling approach, these findings should be considered hypothesis-generating and further research on PNB's association with patient-centered outcomes and implementation strategies may help address these obstacles.