| Study | Reason for exclusion |
|---|---|
| Akhtar 2015 | Not an RCT: the word 'random' is not mentioned anywhere. The methods section does not suggest any form of randomization: "55 patients with a NOF fracture admitted between August 2014 and January 2015 were recruited. 21 patients were given FIBi and 34 (control) had regular analgesia as per trust guidelines" |
| Amini 2012 | Different intervention: addition or not of dexamethasone to nerve block |
| Amiri 2012 | Different intervention: comparison of combined spinal plus femoral nerve block vs lumbar plexus block |
| Anaraki 2012 | Different population: "the primary aim of our study was to investigate the effects of gabapentin and fascia iliaca block on pain score and morphine consumption after femoral shaft surgery" |
| Aprato 2018 | Different intervention: a comparison of fascia‐iliaca compartment block vs intra‐articular hip injection for preoperative pain management in intracapsular hip fracture |
| Arsoy 2017 | Not an RCT: "we retrospectively reviewed all geriatric hip fracture patients who were treated surgically from January 11, 2012 to December 31, 2015" |
| Arsoy 2017a | Not an RCT: "we retrospectively identified 265 consecutive geriatric hip fracture patients who underwent surgical treatment" |
| Barnes 2019 | Not an RCT: "we conducted a prospective case‐control study" |
| Beaudoin 2010 | Not an RCT: "this prospective observational study" |
| Bech 2011 | Different intervention: local anaesthetic infiltration |
| Bendtsen 2014 | "Terminated (less inclusions than expected with the given criteria)" Last update posted: 14 September 2015 |
| Bendtsen 2015 | "Withdrawn (the study was completely redesigned)" Last update posted: 14 September 2015 |
| Bendtsen 2015a | Different intervention: additional nerve blocks if "verbal pain score (0‐10) > 3 at rest or > 5 with passive leg raise 30 minutes after femoral nerve block" |
| Bendtsen 2015b | Not an RCT: validation of a new block technique that could apply to hip fracture |
| Bhadani 2017 | Different population: "in patients with femoral shaft fracture" |
| Bhattacharya 2019 | Different intervention: comparison between 2 different block techniques (i.e. pericapsular nerve group block and fascia iliaca) |
| Bouhours 2010 | Different intervention: "this study compared the reduction in morphine consumption and related side effects of a continuous femoral block with a single shot block in hip‐fracture patients" |
| Bulger 2015 | Different population: 8 participants had no X‐ray‐proven fracture, 3 had a shaft fracture, and 3 had a fracture of acetabulum, pelvis, or pubic ramus. We were unable to obtain data separately for hip fracture only from study authors |
| Callear 2016 | Not an RCT: "the aim of this project was to evaluate the proportion of patients receiving a fascia‐iliac block prior to operative intervention" |
| Candal‐Couto 2005 | Not an RCT: "we studied 30 consecutive patients, regardless of their mental state. One hour following the block, there was a significant improvement in the sitting scores as well as the passive hip flexion (mean increase 44 degrees). Visual analogue scores also improved significantly from 7.2 to 4.6 (S.D. 2.4) in the 18 patients without cognitive impairment. We conclude that fascia iliaca blocks can provide significant benefit in the pre‐operative period and allow patients to sit up more comfortably while they await surgery" |
| Carlisle 2004 | Different population: this was a randomized trial of 62 participants with femoral trauma who were randomized to receive at the site of the accident a femoral nerve block or intravenous metamizole for pain. Study provided a variety of causes for femoral trauma, including 20 cases of hip fracture. The nerve block was shown to reduce the degree of pain as assessed by the visual analogue scale and to reduce anxiety and heart rate. We excluded the study, as it included participants with other conditions. Trialists were unable to provide separate results for hip fracture participants |
| Castillon 2017 | Not an RCT: "a cohort of 216 patients, from January to December 2016, was studied prospectively" |
| Chang 2011 | Not an RCT: observational trial of patients who were never operated |
| Christos 2010 | Not an RCT: educational article on ultrasound‐guided femoral nerve block for hip fracture |
| Dodd 2019 | Different intervention: "objectives: to prove superiority of repeated bolus fascia iliaca catheters compared to single bolus delivered by emergency physicians in emergency hip fractures up to time of surgery" |
| Dulaney‐Cripe 2012 | Not an RCT: "all patients who presented to our institution with a hip fracture were given the option of having a continuous fascia iliaca compartment block for pain control versus usual pain management (non‐opioids, opioids, and ice therapy)" |
| Durrani 2013 | Different population: 47 proximal fractures, 28 shaft fractures, 9 distal fractures. Mean age 42 years Email sent 17 March 2016, to request separate data for participants with a proximal fracture; no reply |
| Elkhodair 2011 | Not an RCT: "a prospective cohort study was carried out on 137 patients" |
| Evans 2019 | Not an RCT: conference abstract trying to identify patient‐prioritized outcomes when evaluating blocks performed by paramedics |
| Finlayson 1988 | Not an RCT: "thirty‐six patients with femoral neck fractures attending the accident department over a three month period received femoral blocks from one of the two authors" |
| Foss 2005 | Different intervention: epidural analgesia |
| Foss 2009 | Not an RCT: "one hundred and seventeen hip fracture patients were included in a descriptive prospective study" |
| Fujihara 2013 | Not an RCT: "the included patients were assigned to one of two groups in alternating order" |
| Gasanova 2019 | Different intervention: comparison between different peripheral nerve blocks |
| George 2016 | Different intervention: trial comparing femoral nerve block vs fascia iliaca compartment block |
| Ghimire 2015 | Different intervention: comparison between fascia iliaca block and femoral nerve block for positioning for spinal anaesthesia |
| Godoy Monzon 2007 | Not an RCT: "after informed consent, a physician administered one FICB to 63 sequential adult ED patients (43 women, 20 men; ages 37‐96 years, mean 73.5 years) with radiographically diagnosed hip fractures" |
| Gorodetskyi 2007 | Different intervention: this was a randomized study of 60 participants with a trochanteric hip fracture fixed with a sliding hip screw or a trochanteric external fixator. After surgery, participants were randomized to an active non‐invasive interactive neurostimulation device or to a sham device. The active device generated biphasic electrical impulses. Participants allocated to the active group had a reduced level of pain, a reduced analgesic requirement, and a greater range of flexion of the injured limb. We excluded the study, as it was not a study of nerve blocks |
| Gosavi 2001 | Not an RCT: all participants had a femoral nerve block |
| Gozlan 2005 | Not an RCT: "étude prospective et descriptive" = prospective and descriptive study |
| Grigg 2009 | Not an RCT: observational report on feasibility of nurses administering a nerve block |
| Groot 2015 | Not an RCT: "between September 2012 and July 2013, we performed a prospective pilot study" |
| Haines 2012 | Not an RCT: "in this prospective, observational, feasibility study", based on published article The trial registry "ClinicalTrial.gov" includes registration NCT01904071 done by one of the study authors (First posted: 22 July 2013; Results first posted: 24 April 2014; Last update posted: 6 June 2018). In the trial registry, one can find results for 3 groups of participants: (1) ultrasound‐guided femoral nerve block, (2) ultrasound‐guided fascia iliaca block, and (3) no block. Characteristics of participants and results of group ultrasound‐guided fascia iliaca published on the website of the trial registry are identical to those published in the observational study, namely, N = 20; age = 82 (SD 7.7) years; female/male = 11/9; and pain score before the procedure = 5.50 (3.99). Furthermore, the trial registry (accessed 27 December 2019) cites the published article summarizing the "observational study" as "Publications of results". For this reason, the study at the trial registry was considered not randomized and was linked to this publication of an observational study The only results available in the trial registry that would have been included in the review are pain at rest 30 minutes after block placement: "1.94 (2.43); 2.05 (2.61); 5.13 (2.70) for ultrasound‐guided femoral nerve block, ultrasound‐guided fascia iliaca block, and no block, respectively, and absence of serious adverse events" |
| Hallberg 2012 | Terminated |
| Hao 2018 | Different intervention: comparison of ultrasound‐guided vs landmark fascia iliaca block; all participants had epidural analgesia for postoperative pain |
| Hauritz 2009 | Not an RCT: all participants had a fascia iliaca block |
| Helsø 2016 | Not an RCT: retrospective trial: "patients were identified from the local database on all hip fracture patients admitted" |
| Hoffmann 2015 | Different intervention: comparison of ultrasound‐guided femoral nerve block vs femoral nerve block with no ultrasound for guidance |
| Hogh 2008 | Not an RCT: "the FIB technique has routinely been used pre‐operatively in the emergency department since 1 January 2004 for all patients with hip fractures. Over an 8‐month period, 187 patients were treated.....Effect of FIB was prospectively assessed on 70 patients" |
| Hussain 2014 | Different intervention: amount of local anaesthetic used (bupivacaine 12.5 mg/kg of body weight) exceeds recommendations |
| Iamaroon 2010 | Different population: although the vast majority of participants had a proximal fracture, 10 participants had a shaft fracture (6 participants for femoral nerve block, 1 for control, or 3 for distal (participants in the control group)). An email was sent on 17 March 2016, to obtain data separately for participants with a proximal fracture; no reply was received |
| Inan 2009 | Different intervention: all participants had a 3‐in‐1 femoral nerve block with or without the addition of oral dexketoprofen |
| Irwin 2012 | Not an RCT: retrospective study |
| Isalgue 2014 | Not an RCT: although the same number of participants was included in the 2 groups, the word 'random' is not mentioned anywhere in the abstract nor in the text |
| Ishioka 2018 | Not an RCT: "basic design: single arm; randomization: non‐randomized" |
| Kacha 2018 | Different population: include patients with acetabular fracture; we were unable to obtain data separately for femur fracture only |
| Kang 2013 | Different intervention: local anaesthetic infiltration |
| Kassam 2018 | Not an RCT: "the first 20 patients (Group A) were treated with traditional analgesia regimen... the second consecutive 20 patients, all underwent a landmark based FIB" |
| Klukowski 2017 | Not an RCT: "a retrospective analysis of perioperative medical records of 78 patients undergoing surgical treatment of proximal femur fractures was performed" |
| Kristek 2019 | Different intervention: "to investigate the possible effect of postoperatively applied analgesics ‐ epidurally applied levobupivacaine or intravenously applied morphine..." |
| Kumar 2016 | Not an RCT: "all 50 patients received an ultrasound guided Fascia Iliaca Compartment Block (FICB)" |
| Kumie 2015 | Not an RCT: single‐institution case control study |
| Lee 2015 | Different intervention: in Abstract, "we conducted a prospective cluster trial, randomized by emergency physicians". The trial, published as a conference abstract, reported that peripheral nerve block use was higher for trained emergency physicians compared with (17/21) those without specific training (1/52) |
| Lee 2016 | Different intervention: randomized by emergency physicians: "all participating emergency physicians (EPs) will be randomly assigned to the order they receive training in a stepped wedge design"; "which block that will be used will be randomly determined at the individual patient level" |
| Leeper 2012 | Not an RCT: "analgesia requirements for all patients admitted with fractured neck of femur to one unit over a 9‐month period were gathered prospectively" |
| Levente 2017 | Not an RCT: prospective observational trial |
| Levine 2003 | Different population: "patients with traumatic mid and distal femur fractures" |
| Li 2013 | Different intervention: all participants had the same blocks; they were randomized by type of general anaesthesia |
| Lopez 2003 | Not an RCT: "a fascia iliaca compartment block was performed on all of them" |
| Mannion 2005 | Different intervention: this was a randomized trial of 36 participants who were having hip fracture surgery. All participants had a psoas block and general anaesthesia. Participants were randomized to 3 groups. A control group received a psoas block and IV saline, another group received psoas block and IV clonidine 1 mg/kg, and a third group received a psoas block and perineural clonidine. The interval from time of completion of block to first supplementary analgesic administration was longer in the IV clonidine group. Results show no significant differences among groups regarding postoperative adverse effects. We excluded the study, as investigators included no 'control' group that received no block |
| Manohara 2015 | Different intervention: comparison between ultrasound‐guided supra‐inguinal fascia iliaca block and femoral nerve block |
| Marhofer 1998 | Different intervention: this was a randomized trial of 60 participants. 20 received a 3‐in‐1 block with ultrasound guidance with 20 mL 0.5% bupivacaine, 20 received 20 mL of 0.5% bupivacaine, and 20 received 30 mL of 0.5% bupivacaine, with nerve stimulator guidance. We excluded the study, as investigators included no comparison with a group without nerve block |
| Masoumi 2014 | Different population: type of fracture: femoral intertrochanteric (N = 30), femoral neck (N = 17), or femoral shaft fracture (N = 13). No email address to obtain results from proximal end fractures separately |
| Matot 2003 | Different intervention: epidural analgesia |
| McGlone 1987 | Not an RCT: "all received a femoral nerve block" |
| McRae 2015 | Different population: 6 participants with shaft fracture. Letter sent 17 March 2016, to request separate data for participants with a proximal fracture; no reply |
| Memary 2015 | Different population: "elective femoral shaft fracture" |
| Mostafa 2015 | Different population: "femur fracture". We were unable to confirm the exact site of femur fracture from study author |
| Mutty 2007 | Different population: this was a randomized trial comparing femoral nerve block vs no block for 54 participants with a femoral shaft or distal femoral fracture. We excluded the study, as it included no proximal femoral fractures |
| Nielsen 2015 | Different intervention: "the aim of this trial is to test the analgesic effect of a femoral nerve block in combination with an obturator nerve block compared to femoral nerve block alone" |
| Pakhare 2016 | Different population: "objective: to compare the analgesic efficacy of femoral nerve block and IV fentanyl in femur shaft fracture patients for positioning them for neuraxial block" |
| Parras 2016 | Different intervention: comparison of quadratus lumborum block type vs femoral nerve block |
| Perrier 2010 | Not an RCT: "prospective, observational study" |
| Piangatelli 2004 | Different intervention: this was a randomized study of 80 participants undergoing lower extremity surgery that compared 4 different methods. A lumbar plexus block with 30 mL 0.5% levobupivacaine or a lumbar plexus block with 30 mL 0.75% ropivacaine or a sciatic nerve block with 10 mL 0.75% ropivacaine or a sciatic nerve block with 10 mL 0.5% levobupivacaine. We excluded the study from this review, as investigators included no 'control' group without nerve block |
| Randall 2008 | Not an RCT: audit on nurse administering peripheral nerve blocks |
| Rapchuk 2013 | Not an RCT: case series of 4 patients |
| Rashwan 2013 | Different intervention: comparison of fascia iliaca vs epidural analgesia |
| Reavley 2015 | Different intervention: comparison between fascia iliaca block and femoral (3‐in‐1) block for preoperative analgesia in the emergency department |
| Reddy 2016 | Different population: 8 participants with shaft fracture and 12 participants with distal femur fracture. We were unable to obtain data for proximal femur fractures separately |
| Rojas Rivera 2002 | Not an RCT: prospective observational study |
| Sahota 2011 | Different intervention: both groups could have a single‐injection block, but the catheter for a continuous infusion was allowed only for the intervention group: "common practice at our institution is to place a femoral nerve block either to facilitate patient positioning for a spinal anaesthetic or as postoperative analgesia in patients having general anaesthesia. This will be permitted in patients in the control group, however catheter insertion is not" |
| Scheinin 2000 | Different intervention: epidural analgesia |
| Segado Jimenez 2010 | Different population: study authors informed us that the trial included participants with hip fracture and participants without hip fracture undergoing elective hip arthroplasty. They could not give us data separately for participants with and without hip fracture: "I did not register which patients were hip fractures, just the type of surgery" |
| Shi 2018 | Different population: hip replacement; the word "fracture" is not mentioned anywhere in the report |
| Sia 2004 | Different population: femoral shaft fractures |
| Siguira 2014 | Terminated on 1 June 2015 |
| Singh 2016 | Different population: intertrochanteric femur fracture (70%), L/C (not defined) femur fracture (1.7%), femoral neck fracture (16.7%), mid‐shaft femur fracture (6.7%), or S/T (not defined) femur fracture (5%). We were unable to obtain data for proximal femur fracture separately |
| Sonawane 2019 | Different intervention: comparison between different peripheral nerve blocks |
| Swart 2017 | Different intervention: "subcutaneous injection at conclusion of surgical fixation of hip fracture" |
| Tao 2016 | Not an RCT: cross‐sectional study to be used for planning an RCT |
| Thakur 2018 | Not an RCT: "observational" |
| Turker 2003 | Different intervention: this was a randomized study of 30 participants who underwent partial hip replacement surgery. 15 received general anaesthesia plus epidural block with 15 mL of 0.5% bupivacaine, and 15 received general anaesthesia plus psoas compartment block with 30 mL of 0.5% bupivacaine. Both groups had similar pain scores, but the epidural group showed greater drops in mean arterial blood pressure from baseline and more complications. We excluded the study from this review because it did not include a control group that did not receive nerve block |
| Van Leeuwen 2000 | Different intervention: this was a randomized study of 3 different combinations of doses of local anaesthetics given to produce a 'three in one' femoral nerve block. We excluded this study from the review because it did not include a 'control' group that did not receive nerve block |
| Vats 2016 | Not an RCT: "in this observational study" |
| Wang 2019 | Not an RCT: "study type: observational study" |
| Wei 2018 | Different intervention: all participants will have a peripheral nerve block |
| WHO Int 2007 | Study terminated in 2010 |
| Williams 2016 | Not an RCT: probably retrospective: "in patients with femoral neck fracture, 69 patients who received standard preoperative analgesia (regular paracetamol 1 g 4 times a day, codeine 60 mg 4 times a day, and opioid 10 mg 2 hourly as required) were compared with 50 patients who received standard preoperative analgesia plus FICB" |
| Zadeh 2015 | Different intervention: comparison of femoral nerve block vs fascia iliaca block |
| Zheng 2017 | Different intervention: comparison of injection below vs at the level of inguinal ligament for fascia iliaca block |
FICB (FIB): fascia iliaca compartment block (fascia iliaca block).
RCT: randomized controlled trial.