The Efficacy of Intravenous Analgesia and Various Nerve Blocks for Pain Management in Elderly Patients With Hip Fractures: A Meta-Analysis.

Publisher: Wiley on behalf of the Chinese Orthopedic Association Country of Publication: Australia NLM ID: 101501666 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1757-7861 (Electronic) Linking ISSN: 17577853 NLM ISO Abbreviation: Orthop Surg Subsets: MEDLINE

Publication: 2013- : Richmond, Vic. Wiley on behalf of the Chinese Orthopedic Association
Original Publication: Richmond, Vic. : Tianjin : Blackwell Pub. Asia ; Tianjin Hospital, 2009-

Hip Fractures*/surgery ; Nerve Block*/methods ; Pain Management*/methods ; Postoperative Pain*/drug therapy ; Analgesia*/methods; Humans ; Aged ; Administration, Intravenous ; Pain Measurement

Pain management in elderly patients with hip fractures has received more and more attention, which is crucial for promoting recovery and reducing complications. At present, there are various and controversial analgesic methods for this population. This meta-analysis evaluated the analgesic effects and side effects of intravenous analgesia compared to different nerve block techniques, including femoral nerve block, fascia iliaca block or pericapsular nerve group block, in this patient group. The study was conducted following the PRISMA 2020 guidelines. A search was performed in October 2024 across PubMed, Web of Science, Cochrane Library, and Embase. Pain scores at different time points, supplemental analgesic morphine consumption, and adverse reactions were compared between intravenous analgesia and nerve blocks. Data were collected from 12 studies and 1157 elderly patients using intravenous analgesia and nerve block after hip fracture, with no differences in sample size, mean age, or percentage of females between the two groups at baseline. Compared to intravenous analgesia, nerve blocks showed significant advantages in the pain score of 2 h after block (SMD-0.80; 95% CI: -1.23 to -0.38; I² = 90%) and the supplemental analgesic morphine consumption (SMD = -0.46; 95% CI: -0.73 to -0.19; I² = 59%). The incidence of adverse reactions and the pain scores at various time points also demonstrated significant differences between the two groups. The application of nerve blocks in elderly patients with hip fractures demonstrates significant clinical advantages, particularly in postoperative pain management, decreasing opioid use, and reducing postoperative complications.
(© 2025 The Author(s). Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd.)

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Keywords: aged; analgesia; hip fractures; meta‐analysis; nerve block

Date Created: 20250610 Date Completed: 20250804 Latest Revision: 20260127

20260130

PMC12318691

10.1111/os.70090

40491168