REHAB Study Version 2.0
Research type
Research Study
Full title
Is the Rate of Early mobilisation in Hip fracture patients using Alfentanil Better than standard opioid analgesia (REHAB): a prospective cohort study
IRAS ID
334525
Contact name
Nicholas Clement
Contact email
Sponsor organisation
NHS Lothian
Duration of Study in the UK
0 years, 2 months, 31 days
Research summary
Hip fractures are amongst the most common orthopaedic injuries. These fractures predominantly occur in the elderly population, secondary to osteoporosis. Patients with these injuries undergo surgery to improve pain and allow them to walk again. Many research studies have shown that early mobilisation after hip fracture surgery provides reduced post operative pain, 30 day complication rates, 30 day mortality rates and reduces length of stay in hospital.
Though early mobilisation may provide numerous post operative benefits, there are barriers to achieving this reliably and effectively. One such difficulty is pain. In the Royal Infirmary of Edinburgh (RIE) like many boards across Scotland, oral oxycodone has been routinely used as analgesia (i.e. painkillers) to help with post operative pain, in patients who have undergone orthopaedic trauma injuries. However, this analgesic modality is utilised to help with general post operative pain, rather than targeted abolition of pain prior to physiotherapy. To the authors knowledge there are no studies or reviews in the literature which have specifically investigated this, nor provided a systematic strategy to tackle post operative pain, to help facilitate early mobilisation.
A preliminary audit conducted locally in NHS Lothian, has identified that use of subcutaneous alfentanil provides superior analgesia compared to the use of routine oral oxycodone by orthopaedic surgical wards across RIE as part of a quality improvement project. The short half-life, combined with the fast onset of analgesic effect, makes alfentanil a favourable analgesic option prior to physiotherapy.
This study will investigate whether sublingual/subcutaneous alfentanil can better facilitate early mobilisation over routine oral oxycodone. 64 patients will be included, 32 in each cohort. All patients undergoing surgery for hip fractures, aged greater than 60.
REC name
East Midlands - Nottingham 1 Research Ethics Committee
REC reference
23/EM/0262
Date of REC Opinion
20 Nov 2023
REC opinion
Favourable Opinion