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 .
Intrathecal morphine for post-operative analgesia in patients with fractured hips.
This prospect i ve , r and omised , double blind study examined the efficacy of intrathecal morphine for post-operative analgesia in Chinese patients undergoing surgery to repair fractured hips . There were a total of 40 American Society of Anesthesiologists physical status grade I to IV patients scheduled for surgery following a fractured neck of the femur . Patients were r and omised to a control group in which they received subarachnoid plain 0.5 % bupivacaine , 2.2 mL , and normal saline , 0.4 mL , giving a total volume of 2.6 mL , or to a study group in which they received plain 0.5 % bupivacaine , 2.2 mL , and preservative-free morphine , 0.2 mg , diluted with normal saline to a total volume of 2.6 mL. Patients were monitored for up to 24 hours by staff blinded to group allocation . The level of pain was assessed by a visual analogue pain score and the time of first request for analgesia was noted . The results show the median pain-free period in the control group was nine hours ( range , 2 - 24 hours ) , while it was 24 hours ( range , 16 - 24 hours ) in the morphine group , a significant difference ( P<0.05 ) . No major complications were reported . Intrathecal morphine is a useful technique for giving post-operative pain relief , especially in the elderly , in whom many other techniques can not be safely used
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 .