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Pain Management Interventions for Hip Fracture

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Effectiveness of Nerve Block on Acute Pain: Trials and Results

Several versions of peripheral nerve block techniques have been examined—in comparison to usual care or to epidural or spinal anesthesia—to determine their comparative effectiveness against acute pain. These blocks have been used preoperatively, intraoperatively, and postoperatively. The only interventions that do not show greater relief from pain than usual care alone are 3-in-1 blocks performed postoperatively and preoperative fascia iliaca block in one report. For the combined literature about nerve blocks, the strength of evidence is moderate that they can reduce pain as well as or better than standard care alone. Three types of block were compared with epidural and spinal anesthesia in intraoperative use for effectiveness against acute pain. The results show that there is no statistically significant difference between these interventions for relief from pain, but the strength of evidence is low.