Pain relief management following proximal femoral fractures: Options, issues and controversies.
The majority of proximal femoral fractures occur in the elderly population. Safe and adequate pain relief is an integral part of the overall management of hip fractures. Inherent difficulties in the assessment of pain in elderly need to be taken into account and unique considerations should be made regarding the effective analgesia due to different elderly physiology, and their response to trauma and subsequent surgery. The pain management should start as soon as possible and special emphasis should be paid to contemporary methods of regional anaesthesia whilst a multimodal approach should be adopted in the perioperative period. The present review summarises the contemporary treatment options and controversies pertaining to the management of pain in elderly patients with proximal femoral fractures.
Academic Department of Trauma & Orthopaedic Surgery, University of Leeds, Clarendon Wing, Leeds General Infirmary, Floor A, Great George Street, LS1 3EX Leeds, UK; NIHR Leeds Biomedical Research Unit, Chapel Allerton Hospital, LS7 4SA Leeds, West Yorkshire, UK. Electronic address: ttosounidis@yahoo.com.
Theodoros H
TH
Tosounidis
Academic Department of Trauma & Orthopaedic Surgery, University of Leeds, Clarendon Wing, Leeds General Infirmary, Floor A, Great George Street, LS1 3EX Leeds, UK.
Hassaan
H
Sheikh
Hip Reconstruction Unit, Chapel Allerton Hospital, Leeds, West Yorkshire, LS7 4SA, UK; NIHR Leeds Biomedical Research Unit, Chapel Allerton Hospital, LS7 4SA Leeds, West Yorkshire, UK.
Martin H
MH
Stone
Academic Department of Trauma & Orthopaedic Surgery, University of Leeds, Clarendon Wing, Leeds General Infirmary, Floor A, Great George Street, LS1 3EX Leeds, UK; NIHR Leeds Biomedical Research Unit, Chapel Allerton Hospital, LS7 4SA Leeds, West Yorkshire, UK.
Peter V
PV
Giannoudis
D000368:Aged; D000369:Aged, 80 and over; D000698:Analgesia / Q000379:methods*; D005264:Femoral Fractures / Q000150:complications* / Q000503:physiopathology / Q000601:surgery*; D005267:Femoral Nerve / Q000187:drug effects; D005593:Fracture Fixation, Internal / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007431:Intraoperative Complications / Q000188:drug therapy; D009407:Nerve Block; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome
Analgesia; Elderly; Hip fractures; Pain; Proximal femoral fractures