Evidence map›Paper›PMID 40188080›Full record

ArticleTrials2025

Effects of opioid-free anesthesia combined with iliofascial nerve block on perioperative neurocognitive deficits in elderly patients undergoing hip fracture surgery: study protocol for a prospective, multicenter, parallel-group, randomized controlled trial.

Tong Zhi, Shirong Wei, Jiao Kuang, Sitong Zhou, Danhong Yu, Tesheng Gao, Long Lei, Chengfei Xu, Liang Cheng, Qinghe Zhou and 2 more

Abstract readClinical Trial Protocol
In one paragraph

Article in Trials, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Observational
  5. Article
  6. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Tong ZhiDepartment of Anesthesiology and Pain Research Center, The Affiliated Hospital of Jiaxing University, 1882 Zhonghuan South Road, Jiaxing, 314001, China.
Shirong WeiDepartment of Anesthesiology and Pain Research Center, The Affiliated Hospital of Jiaxing University, 1882 Zhonghuan South Road, Jiaxing, 314001, China.
Jiao KuangDepartment of Anesthesiology and Pain Research Center, The Affiliated Hospital of Jiaxing University, 1882 Zhonghuan South Road, Jiaxing, 314001, China.
Sitong ZhouDepartment of Anesthesiology and Pain Research Center, The Affiliated Hospital of Jiaxing University, 1882 Zhonghuan South Road, Jiaxing, 314001, China.
Danhong YuDepartment of Anesthesiology and Pain Research Center, The Affiliated Hospital of Jiaxing University, 1882 Zhonghuan South Road, Jiaxing, 314001, China.
Tesheng GaoDepartment of Anaesthesiology, Jiaxing Chinese Medical Hospital, No. 1501, Zhongshan East RoadZhejiang Province, Jiaxing, 314001, China.
Long LeiDepartment of Anesthesiology, Zhejiang Rongjun Hospital, the Third Affiliated Hospital of Jiaxing University School of Medicine, 309 Shuangyuan Road, Jiaxing, 314000, China.
Chengfei XuDepartment of Anesthesiology, The Third People'S Hospital of Bengbu, Bengbu, 233000, China.
Liang ChengDepartment of Anesthesiology, The Third People'S Hospital of Bengbu, Bengbu, 233000, China.
Qinghe ZhouDepartment of Anesthesiology and Pain Research Center, The Affiliated Hospital of Jiaxing University, 1882 Zhonghuan South Road, Jiaxing, 314001, China.
Ming YaoDepartment of Anesthesiology and Pain Research Center, The Affiliated Hospital of Jiaxing University, 1882 Zhonghuan South Road, Jiaxing, 314001, China.
Huadong NiDepartment of Anesthesiology and Pain Research Center, The Affiliated Hospital of Jiaxing University, 1882 Zhonghuan South Road, Jiaxing, 314001, China. huadongni@zjxu.edu.cn.ORCID http://orcid.org/0009-0007-8225-2605

Funding

National Key Clinical Specialty Discipline Construction Program of China 2023ZJZK001Scientific Research Fund of National Health Commission-Zhejiang Provincial Health Major science and technology Plan project WKJ-ZJ-2448
6 · The paper itself

Abstract

backgroundPerioperative neurocognitive dysfunction (PND), a prevalent complication affecting elderly surgical patients, poses substantial challenges to postoperative rehabilitation and long-term functional independence. Despite growing awareness of its clinical significance, current evidence regarding effective neuroprotective anesthetic strategies remains inconclusive. Where emerging evidence suggests opioid-free anesthesia (OFA) strategies could maintain analgesic efficacy while potentially attenuating opioid-associated neuroinflammatory mechanisms implicated in PND pathogenesis. This multicenter trial investigates the efficacy of OFA combined with ultrasound-guided iliofascial nerve block in mitigating PND among geriatric patients undergoing hip fracture surgery.

methodsThis multicenter, randomized controlled trial will enroll 348 patients, who will be randomly assigned to receive either OFA combined with iliofascial nerve block or opioid-based anesthesia (OBA) combined with iliofascial nerve block. All patients will undergo hip fracture surgery under general anesthesia with tracheal intubation. The primary outcome will be the change in composite neurocognitive scores, assessed through a battery of neuropsychological tests from baseline to 3 months postoperatively. Secondary outcomes include alterations in serum protein and inflammatory markers, extubation time, postoperative pain incidence, intraoperative hemodynamic stability, and postoperative recovery parameters. The safety profile of OFA in hip surgery will also be assessed. DISCUSSION: Effective prevention of PND is crucial for optimizing postoperative recovery and long-term functional outcomes in elderly patients. This trial aims to refine and optimize anesthesia management strategies to reduce the incidence of PND, improve postoperative quality of life, and ultimately enhance perioperative neurocognitive outcomes.

trial registrationThis trial protocol was registered with the China Clinical Trial Registry on December 14, 2023, under the registration number: ChiCTR2300078647.

Indexed as

Anesthesia, GeneralHip FracturesNerve BlockNeurocognitive DisordersPostoperative Cognitive ComplicationsAgedAnalgesics, OpioidCognitionFemaleHumansMaleMulticenter Studies as TopicPostoperative PainProspective StudiesRandomized Controlled Trials as TopicTreatment OutcomeAnalgesics, OpioidElderly patientsHip fracture surgeryIliofascial nerve blockOpioid-free anesthesiaPerioperative neurocognitive disorders

Identifiers

PMID40188080
PMCPMC11972513

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.