Anesthesia clinicians' perspectives on peripheral nerve blocks for hip fractures in older adults.

INTRODUCTION: Peripheral nerve blocks (PNBs) have emerged as a promising pain management strategy for older adults undergoing hip fracture surgery. This study aimed to identify factors influencing PNB use and assess opinions on their effectiveness and implementation among physician anesthesiologists, certified registered nurse anesthetists (CRNAs), and certified anesthesiologist assistants (CAAs). METHODS: A cross-sectional study surveyed physician anesthesiologists, CRNAs, and CAAs caring for adults aged 50 years and older with hip fractures from May 2024 to July 2024. The 22-item questionnaire explored demographics, PNB practices, perceived advantages, disadvantages, barriers to use, and interest in future research. RESULTS: A total of 185 surveys were returned: 94.5% from physician anesthesiologists, 4.9% from CRNAs, and 0.5% from a CAA. While 86% of respondents perceived PNBs as beneficial, 14% reported they were unsure or opposed the use of PNB for older adults undergoing surgical fixation of hip fractures. The reported primary perceived advantages of using PNB in older adults with hip fractures included reduced pain and decreased opioid use within 72 h postoperatively. The reported primary difficulties in using PNB included surgical delays and institutional culture against PNB use. Most respondents (86%) supported further research on PNB outcomes to assess if benefits beyond acute pain exist. CONCLUSION: The majority of anesthesia clinicians surveyed perceived PNBs as potentially beneficial for pain management in hip fracture patients. However, numerous reported barriers to PNB use were identified. Given the convenience sampling approach, these findings should be considered hypothesis-generating and further research on PNB's association with patient-centered outcomes and implementation strategies may help address these obstacles.