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Master Thesis

Impact de la pose précoce préopératoire d'un cathéter ilio fascial à visée antalgique dans la fracture de l'extrémité supérieure du fémur chez le patient de plus de 75 ans : étude « SURF »

Abstract : Introduction: The hip fracture is a frequent pathology of the elderly and has serious consequences in terms of morbidity and mortality. At one year post-fracture, 20% of patients have lost the ability to walk, 30 to 50% are partially dependent, and 30% are totally dependent. The main factors limiting functional recovery are pain and communication disorders, which may result from analgesic drug iatrogeny. Early optimisation of walking rehabilitation is therefore essential, and requires optimal analgesia, with the lowest possible iatrogenicity, in order to prevent loss of independence. The aim of our study is to evaluate the effects of prolonged analgesia through early placement of an iliofascial catheter (IFC) on functional and motor recovery. Method: We designed a multicentre study, on the orthogeriatric units on the CHU Grenoble Alpes, CHU Saint-Etienne, CHU Clermont Ferrand, CHU Lyon Edouard Herriot and CHU Lyon Sud. This is a prospective, randomized, controlled, double-blind study of Ropivacaine treatment administered via a continuous ilio-fascial peri-nervous catheter preoperatively versus placebo in patients aged 75 years or older admitted for ESF. We will study the effects of this perioperative pre-habilitation on the time to return to walking in the postoperative period, defined as a displacement of 3 meters or more. Results: Our initial hypothesis aims to demonstrate a 30% improvement in the time to return to walking in patients receiving IFC. The number of subjects needed to demonstrate this difference is 260, over a 2-year inclusion period. Conclusion: This study could allow the integration of IFC in the management of patients over 75 years of age admitted for hip fracture.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03344097
Contributor : Jean-Hugues Morneau Connect in order to contact the contributor
Submitted on : Tuesday, September 14, 2021 - 3:39:36 PM
Last modification on : Friday, September 17, 2021 - 3:21:43 AM

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  • HAL Id : dumas-03344097, version 1

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Thibault Charavel. Impact de la pose précoce préopératoire d'un cathéter ilio fascial à visée antalgique dans la fracture de l'extrémité supérieure du fémur chez le patient de plus de 75 ans : étude « SURF ». Médecine humaine et pathologie. 2021. ⟨dumas-03344097⟩

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