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 .
[Efficacy of obturator and femoral cutaneous nerve blocks for postoperative analgesia in hip surgery].
OBJECTIVES The treatment of pain after surgery to repair a hip fracture is essential for an early start of rehabilitation and for reducing morbidity and mortality . Given that patients are elderly and have multiple medical conditions , local-regional analgesia can be an effective approach . Our aim was to compare the efficacy of obturator and femoral cutaneous nerve blocks and total intravenous analgesia in terms of level of patient satisfaction , complications , start of rehabilitation , and cost . PATIENTS AND METHODS Prospect i ve study of 75 patients undergoing surgery to repair hip fractures . Patients were r and omized to receive intravenous analgesia only , blockade of both nerves , or blockade of only the obturator nerve .  In each group we recorded visual analog scale ( VAS ) pain scores , satisfaction with postoperative analgesia , time elapsed until start of rehabilitation , need for postoperative analgesics , side effects , and the cost of drugs . RESULTS Analgesia was significantly more effective in patients with nerve blocks than in those who received only intravenous analgesia ( mean [ SD ] VAS scores , 2.6 [ 1.4 ] and 5.6 [ 0.7 ] , respectively ) . Patients with nerve blocks also had a pain-free period of more than 24 hours ( P < .001 ) , needed fewer doses of supplementary analgesics or other drugs , had fewer side effects ( P < .01 ) , started rehabilitation earlier ( 32.6 [ 5.4 ] hours vs 45.7 [ 8.2 ] hours ) , generated less expenditure ( 2.6 Euros [ 1.5 Euros]/patient vs 7.0 Euros [ 0.4 Euros]/patient ) . The tested techniques had no complications . CONCLUSIONS The nerve blocks were effective , easy to perform , and safe . They afforded numerous advantages : extended period of postoperative analgesia , fast recovery , lower costs , and no complications
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 .