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 .
Fascia Iliaca Compartment Blockade for Acute Pain Control in Hip Fracture Patients: A Randomized, Placebo-controlled Trial
Background : Hip fracture patients are in severe pain upon arrival at the emergency department . Pain treatment is traditionally based on systemic opioids . No study has examined the effect of fascia iliaca compartment blockade ( FICB ) in acute hip fracture pain management within a double-blind , r and omized setup . Methods : Forty-eight patients with suspected hip fracture were included immediately after arrival in the emergency department , before x-ray confirmation of their fracture . Included patients were r and omly assigned to two groups of 24 . In the FICB group , the patients received an FICB with 1.0 % mepivacaine and a placebo intramuscular injection of isotonic saline . In the morphine group , the patients received a placebo FICB with 0.9 % saline and an intramuscular injection of 0.1 mg/kg morphine . Patients received intravenous rescue morphine when necessary . Results : Maximum pain relief was superior in the FICB group both at rest ( P < 0.01 ) and on movement ( P = 0.02 ) . The median total morphine consumption was 0 mg ( interquartile range , 0–0 mg ) in the FICB group and 6 mg ( interquartile range , 5–7 mg ) in the morphine group ( P < 0.01 ) . More patients ( P = 0.05 ) were se date d in the morphine group at 180 min after block placement as compared with the FICB group . Conclusion : Pain relief was superior at all times and at all measurements in the FICB group . The study supports the use of FICB in acute management of hip fracture pain because it is an effective , easily learned procedure that also may reduce opioid side effects in this fragile , elderly group of patients
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 .