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 .
Hypotension Induced by Lateral Decubitus or Supine Spinal Anaesthesia in Elderly With Low Ejection Fraction Undergone Hip Surgery
Summary Objective The aim of the study was to assess the effect of low ejection fraction ( EF ) on hypotension during lateral or supine position of spinal anaesthesia in patients older than 75 years old . Methods We analyzed 41 patients who had undergone hip surgery between August 2000 and October 2001 in the Aydin SSK State Hospital retrospectively . Patients older than 75 years of age and an EF less than 50 % were selected and spinal anaesthesia was performed with hyperbaric bupivacaine 0.5 % , lateral decubitus or supine position . The patients were divided into two groups : Group I ( unilateral group , n = 23 ) and Group II ( supine group , n = 18 ) . History of hypertension , diabetes mellitus , and ASA status , preoperative value of EF and cardiac index , and intraoperative hypotension , bradycardia , ephedrine use , and maximal sensorial block levels were recorded . Results The age range of patients was between 75 and 103 . The maximal sensorial block level was evaluated due to lower or higher than thoracic sixth segment for each patient in intraoperative period . The sensorial block level higher than thoracic sixth segment were determined 2 patient in Group I and 14 patients in Group II ( p = 0.001 ) . Hypotension was observed in five patients in Group I and 10 patients in Group II ( p = 0.015 ) . In Group I , the number of ephedrine used patient was lower than Group II ( p = 0.015 ) . Conclusions Elderly patients with low EF were more likely to predispose to higher sensorial block level and hypotension was more common during spinal anaesthesia with supine position compared to lateral decubitus position
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 .