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EP242 Hip fracture surgery – Is the anaesthesia practice changing post COVID-19 pandemic? – An online survey of anaesthetists
  1. Vitul Manhas,
  2. Shashikant Yegnaram and
  3. Vipul Kaushik
  1. Anaesthesia, University hospital Leicester NHS trust, Leicester, UK


Background and Aims According to national hip fracture database report 2022 nearly 75000 patients a year need hospital admission with hip fracture and some of them need surgery. AAGBI 2020 hip fracture guidelines suggests use of either general or spinal anaesthesia with a nerve block. We aimed to look at how the anaesthetic and postoperative analgesia techniques have evolved across UK post COVID 19 pandemic in comparison to existing guidelines.

Methods We conducted an online international survey of anaesthetists who work in trauma list along with an infographic of various nerve blocks for hip fracture. We publicised through emails, social media and face to face during RA-UK conference 2023. We had 64 responses with the participation

(48) skewed towards East midlands region of England.

Results In Hip fracture database of England and Wales 2019 report 57.2% patients had general anaesthesia with nerve block and 39.8% had spinal anaesthesia with nerve block. In our survey anaesthetists’ preference has changed drastically with 76.6% preferring spinal anaesthesia with nerve block and 10.9% preferring general anaesthesia with nerve block. 6.3% of responding anaesthetists do not prefer to perform any nerve blocks.

Abstract EP242 Figure 1

35 out of 64 were consultant anaesthetists with a good mix of doing trauma list frequently and to rarely

Abstract EP242 Figure 2

49 respondents preferred spinal anaesthesia with multimodal analgesia including nerve block and for the choice of nerve block majority preferred between USG guided femoral nerve block (26) or USG guided supra-inguinal fascia iliaca block (16) or USG guided infra-inguinal fascia iliaca block (11)

Conclusions We conclude that post COVID-19, there’s a slight shift towards regional anesthesia, specifically spinal anesthesia with nerve block for hip fracture surgeries. However, our survey results may not be applicable beyond the East Midlands region. Also based on the results of our survey, we aim to improve compliance to AAGBI Hip fracture guidelines by setting up monthly Plan A nerve block teaching sessions in our hospital.

Regional block for hip fractures jpg

  • Hip fracture surgery
  • Plan A blocks
  • Regional anaesthesia

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