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 .
Spinal-induced Hypotension in Elderly Patients with Hip Fracture. A Comparison of Glucose-free Bupivacaine with Glucose-free Bupivacaine and Fentanyl
Intraoperative hypotension is a common and potentially deleterious event in elderly patients undergoing spinal anaesthesia for repair of hip fractures . The synergism between intrathecal opioids and local anaesthetics may allow a reduction in the dose of local anaesthetic and cause less sympathetic block and hypotension , while still maintaining adequate anaesthesia . We studied 40 elderly patients having either an insertion of a dynamic hip screw or a hemi-arthroplasty and compared 9.0 mg glucose-free bupivacaine with added fentanyl 20 μg ( group BF ) with 11.0 m glucose-free bupivacaine alone ( group B ) . Hypotension was defined as a fall in systolic blood pressure to less than 75 % baseline or less than 90 mmHg . The incidence and frequency of hypotension in group BF were less than in group B. Similarly , falls in systolic , diastolic and mean blood pressures were all less in group BF than in group B. However , there were four failed blocks in group BF and one in group
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 .