Analgesia requirements following hip fracture in the cognitively impaired.
The analgesia received in the 1st week of treatment by 100 consecutive acute hip fracture patients (88 female) was prospectively studied. A modified mental test was performed on all patients prior to surgery. Patients with cognitive impairment (modified mental score <5) received only 74% of the paracetamol, 43% of the non-steroidal anti-inflammatory drugs (NSAIDs), 52% of the opioid and 64% of the morphine that cognitively intact patients received. These differences were significant for paracetamol (Mann-Whitney test; p=0.001) and opioid (Mann-Whitney test; p=0. 0012) but not for NSAIDs or morphine. Either hip fracture patients with a reduced mental score perceive less pain than their more cognisant peers, or the treating clinicians perceive their pain as less, or both.
Forster
M C
MC
Department of Trauma and Orthopaedics, Derbyshire Royal Infirmary, London Road, Derby, UK. mcforster@doctors.org.uk
Pardiwala
A
A
Calthorpe
D
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000008:administration & dosage*; D003072:Cognition Disorders / Q000150:complications*; D005260:Female; D005265:Femoral Neck Fractures / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies
D000700:Analgesics