Orthopaedic surgeons' perspectives on peripheral nerve blocks for surgical fixation of hip fractures in older adults

Objectives: This study aimed to identify factors influencing orthopaedic surgeons' decision to request peripheral nerve blocks (PNBs) for older adults undergoing hip fracture surgery and to assess the need for further research. Design: A cross-sectional survey. Setting: Academic and private practice. Participants: One hundred twenty-nine orthopaedic surgeons. Intervention: A 24-question survey assessed PNB usage, perceived advantages and disadvantages. Main Outcome Measures: Survey responses describing factors influencing orthopaedic surgeons' decision to request PNBs for older adults undergoing hip fracture surgery. Results: Seventy-one percent of orthopaedic surgeons reported they believed there were benefits to using PNBs for older adults undergoing surgical fixation of hip fractures. The main perceived advantages were reduced pain and opioid use within 72 hours postoperatively. Primary concerns about PNB use were the negative impact on clinical care efficiency and delayed mobilization. Most surgeons (85%) agreed that higher-level evidence investigating benefits beyond acute postoperative pain control would aid decision-making. Conclusion: Surgeons believe PNBs provide acute postoperative analgesic benefits; however, concerns about delaying clinical care have likely limited widespread implementation. If future research demonstrates the effectiveness of PNBs beyond acute pain relief, it may further motivate healthcare systems to solve workflow challenges and increase the use of PNBs for hip fracture surgery. Level of Evidence: III, Cross-Sectional Study.