Perioperative Pain Management in Elderly Patients With Proximal Femur Fractures: Randomized Controlled Study

Proximal femur fractures are most common fractures in the elderly and associated with significant mortality and morbidity, with high economic and social impact. Perioperative pain management influence outcomes and mortality after surgery with early mobilization being possible. The goal of the study was to compare the efficacy and safety of the compartment psoas block with spinal and general anesthesia. We included 150 patients in this randomized controlled study. The most effective technique of analgesia was prolonged compartment psoas block, which starts from hospital admission and 3 days after surgery, and was associated with better pain control, decreased opioid consumption, better sleep quality, earlier mobilization after surgery, decreased incidence of opioidassociated vomiting/nausea and myocardial injury. There were no difference in the incidence of hospital acquired pneumonia and delirium.