Ultrasound-Guided Regional Anesthesia by Emergency Physicians for Hip Fractures and Delirium: A Randomized Clinical Trial
Lee JS, et al. JAMA Netw Open. 2025 Dec 1;8(12):e2549337. doi: 10.1001/jamanetworkopen.2025.49337.
Methodology: 4/5
Usefulness: 4/5
Question and Methods: Does training emergency physicians to perform ultrasound-guided regional anesthesia for hip fractures reduces incident delirium using a multicenter stepped-wedge cluster randomized trial.
Findings: UGRA use increased from ~2% to ~53% after training and was associated with reduced incident delirium (adjusted OR ≈0.72, 95% CI), without affecting delirium duration and with minimal complications.
Limitations: Open-label design, lower than anticipated sample size, incomplete block delivery, and large site variation in in incidence of delirium.
Interpretation: This study supports ED-performed UGRA as a feasible, low-risk intervention that can meaningfully reduce delirium risk in older hip fracture patients and should be considered for routine ED practice.
For more on performing a hip block, read on the SIFI block here, and IIFI block here.
