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. 2017 May 11;2017(5):CD001159. doi: 10.1002/14651858.CD001159.pub2

Luger 2012.

Methods RCT
Approved by the ethics committee and written informed consents obtained
Setting: Austria
Funding: departmental resources
Participants Included: 37 very elderly participants (> 80 years) with hip fractures (of whom 3 with dementia had to be excluded) scheduled for surgery under spinal anaesthesia
Excluded: score < 18 on the Mini‐Mental State Examination, surgery did not take place within 36 hours, known intolerance or allergies to drugs, planned or required general anaesthesia, refusal of consent, participation in a different study, administration of midazolam as premedication, chronic pain, contraindications and spinal anaesthesia failure, incomplete data records
Interventions Treatment groups: ultrasound‐guided continuous femoral (3‐in‐1) nerve block with bupivacaine (n = 10)
Control group: systemic analgesia with IV/SC piritramide and IV paracetamol (n = 10)
Outcomes Pain scores at rest and on movement at 24 hours after surgery
Opioids at 24 hours after surgery
Number of participants with postoperative myocardial ischaemia
Notes Study also includes a group with epidural analgesia ‐ not retained in this review
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk "The patients were randomized according to a computer‐generated randomization list"
Allocation concealment (selection bias) Unclear risk Not mentioned
Blinding of participants and personnel (performance bias) 
 All outcomes Unclear risk Not mentioned
Blinding of outcome assessment (detection bias) 
 All outcomes Unclear risk Not mentioned
Incomplete outcome data (attrition bias) 
 All outcomes Low risk No drop‐out for the 2 included subgroups
Selective reporting (reporting bias) Low risk All measurements mentioned in methods section given in results section
Other bias Low risk Groups comparable