This study described that intra-articular hip injection (IAHI) provides better pre-operatory pain management in elder patients with intracapsular hip fractures. Also, IAHI could extend the benefits of fascia-iliaca compartment block (FICB) and ameliorate hospitalization conditions. There was a significantly lower dose of opioids administered to the patients who received the IAHI, reducing related risks and side effects.

This study focused on comparing the fascia-iliaca compartment block and the intra-articular hip injection concerning pain management and the need for further systemic analgesia in the pre-operative phase of intracapsular hip fractures.

Patients >65 years old with an intracapsular hip fracture were randomized in this prospective, blind, controlled, parallel trial. The patients were randomly designated to receive either the fascia-iliaca compartment block (cohort FICB) or the intra-articular hip injection (cohort IAHI) when admitted to the emergency department. At rest and during internal rotation of fractured limb, the primary outcome comprised of pain relief at 20 min, 12 hrs, 24 hrs and 48 hrs after the regional anaesthesia. The Numeric Rating Scale was utilized for the same. The same procedure was used to manage residual pain in all the patients. Additional analgesic drug administration during the 48 hrs from admission was noted.

All in all, 120 patients with comparable baseline characteristics were considered for this study: the FICB group comprised of 70 subjects, while the IAHI group consist of 50 subjects. The pain was significantly lower in the IAHI group during movement of the fractured limb at 20 min, 12 hrs, 24 hrs and 48 hrs. In the FICB cohort, 72.9% of patients were required to take oxycodone, in contrast to 28.6% in the IAHI cohort. In the FICB cohort, 14.09 ± 11.57 mg of oxycodone was administered, whereas, in the IAHI cohort, it was 4.38 ± 7.63 mg. There were no adverse events observed in both groups.

Intra-articular hip injection provides better pre-operative pain relief in elder patients suffering from intracapsular hip fractures as compared to the fascia-iliaca compartment block. The need for additional systemic analgesia was also reduced with intra-articular hip injection.