Overall , moderate evidence suggests that nerve blockades are effective for relieving acute pain and reducing delirium .
Low-level evidence suggests that preoperative traction does not reduce acute pain .
Nerve blockade seems to be effective in reducing acute pain after hip fracture .
Sparse data preclude firm conclusions about the relative benefits or harms of many other pain management interventions for patients with hip fracture .
BACKGROUND  Pain management  is integral to the management of hip fracture .
PURPOSE To review the benefits and harms of pharmacologic and nonpharmacologic interventions for managing pain  after hip fracture .
[Comparison of the hemodynamic response in subarachnoid anesthesia with bupivacaine versus bupivacaine with fentanyl in traumatology surgery in elderly patients].
OBJECTIVES To compare the intraoperative hemodynamic effects and ephedrine requirements in elderly patients undergoing orthopedic surgery under subarachnoid anesthesia with hyperbaric bupivacaine with or without fentanyl .  MATERIAL AND METHODS Sixty patients over 75 years of age and scheduled for semi-urgent surgical repair of a fractured femur were r and omized to two groups . Group F received subarachnoid surgery with 5 mg of bupivacaine and 15 micrograms of fentanyl . Group B received 7.5 mg bupivacaine . We recorded blood pressure , heart rate and oxygen saturation every 5 minutes and extension of anesthesia . Hemodynamic changes and ephedrine  required by each patient were analyzed , along with side effects . RESULTS Group F patients were more hemodynamically stable 10 and 20 minutes after infusion of the anesthetic , and more hypotensive episodes occurred in group B. Group B consumed significantly more  ephedrine  ( p < 0.05 ) , administered to 22 patients in group B and 6 in group F. The total dose of ephedrine  administered was greater in group B ( 190 mg ) than in group F ( 40 mg ) . The extension of anesthetic block was sufficient for surgery in all cases . No side effects from fentanyl administration were observed . CONCLUSION Adding fentanyl to the local anesthetic used for subarachnoid anesthesia in elderly patients is effective for maintaining greater hemodynamic stability , allowing use of a lower dose of hyperbaric bupivacaine and reducing the need for intravenous ephedrine during surgery
Overall , moderate evidence suggests that nerve blockades are effective for relieving acute pain and reducing delirium .
Low-level evidence suggests that preoperative traction does not reduce acute pain .
Nerve blockade seems to be effective in reducing acute pain after hip fracture .
Sparse data preclude firm conclusions about the relative benefits or harms of many other pain management interventions for patients with hip fracture .
BACKGROUND  Pain management  is integral to the management of hip fracture .
PURPOSE To review the benefits and harms of pharmacologic and nonpharmacologic interventions for managing pain  after hip fracture .