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

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). 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. 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. 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.

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Publication Details

Journal
BMC Anesthesiology
Published
2026-02-18
DOI
https://doi.org/10.1186/s12871-026-03691-5
Primary Topic
Hip and Femur Fractures
Type
article
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article

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

Shannon J. Hagan, Joseph Evan Villaluz, Christopher Prabhakar, Jason C. Brookman et al.
BMC Anesthesiology
Hip and Femur Fractures
article

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

Shannon J. Hagan, Joseph Evan Villaluz, Christopher Prabhakar, Jason C. Brookman, Thomas Baribeault, David Velasco Villanueva, Reva Ramlogan, Pilar Rubio Babiano, Al May, Guillermo Sarmentero-López de Quintana, Ramola Bhambhani, Francesca Mulazzani, Mary Scott‐Herring, Kara Segna, Jeremy Kaplowitz, Steven B. Porter, Katherine Bupp, Flávia K. Borges, Marlou Vogel, Sudipta Sen, Bianca Conti, Matthias Desmet, Henrique Doria De Vasconcellos, JinLei Li, David Sanz Bedate, Raquel Iglesias Blanco, Ron E. Samet, Frederick E. Sieber, Danial Shams, Bonjo Batoon, D. McIsaac, Nicholas Statzer, Raymond S. Tang, Justin E. Richards, Luis Fernando Valdés-Vilches, Shawn Banks, Erin Treacy, Hassan Rayaz, Nicolas Dorsey, Elena Carrasco Serrano, Samir I. Thaker, Kellie M. Jaremko, Iain Moppett, Arissa M. Torrie, Irina Gasanova, Veena Graff, Gulraj Chawla, Kyle Ahn, Derek J Dillane, HM Marie, Ana Fernández Urbón, Jeremy Wong, Sara Cocho Crespo, Kathleen Tyson, Lisa Gu, Gloria Cheng, B. Gerlach, Jose Caldentey, Harry C. Sherman, Yuqi Gu, Yar Luan Yeap, Andrew H. Tran, Carlota Gordaliza, John Sours, Rita Rodríguez Jiménez, Ruiz Lopez Nuria, Justin Jones, Sheila Sprague, Rebecca L. Johnson, John W. Wolfe, John C. Alexander, Nathan N. O’Hara, Rocío Gutiérrez Bustillo, María García Gento, Michael Herrick, M. Bardají-Carrillo, Julie M. Marshall, Lidia Mora Miquel, Gerard P. Slobogean, David Price, David F. Cantú-de León, William Clark, William Warren, Blanca O. Lea, Mark D. Neuman, Jonathan Wright (1257306), M. Cardozo-Panof, Daniel Perez, Ramin Rahimian, Artin Bastani, Michael Kerr, Steven Hedgecorth, Rodrigo Poves-Álvarez, Jordanna Almeida Cristo-Barbosa, Sripad Rao, James K. Kim, Jason B. Ochroch, Henar Muñoz Hernandez, Beatriz Francisco Sánchez, A. Courtney, Angel Fernández-Collantes, Ignacio Puig Ortega, Laura E. W. Chin, M. T. Peláez-Jareño, Ravi Anandampillai, Yvette Fouche Weber, Brandon Pruett, J. Alex Wharton, Mark Hoeft, The Survey Respondents, Clayton Cheney, Peter Rock, Kamen Vlassakov, Subha Brata Bagchi, Alex Zyernov, Balram Sharma
article en

Abstract

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). 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. 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. 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.

BMC AnesthesiologyVol. 26(1)
University of Maryland, Baltimore (US), Edgewood University (US), Johns Hopkins University (US), University of California, Irvine (US), Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda (IT), Irvine University (US), University of Pennsylvania (US), McMaster University (CA)
Openalex Percentile: Top 51%
Hip and Femur Fractures
DOIOpen Access PDFOpenAlex
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