Role of Peripheral Nerve Blocks in the Preoperative Pain Management of Hip Fractures in the Elderly: a narrative review

Introduction: Hip fractures among geriatric patients present significant challenges for effective pain management and overall patient care. This review explores the role of peripheral nerve blocks in addressing preoperative pain in elderly hip fracture patients, considering the limitations of conventional analgesic approaches. Methods: A literature search with Pubmed and Google Scholar was conducted, identifying 26 relevant studies encompassing randomized controlled trials and observational cohort studies. The efficacy of various nerve block techniques, including femoral nerve, fascia iliaca compartment, and pericapsular nerve group blocks, were analyzed. Results: Peripheral nerve blocks demonstrated consistent benefits in pain relief, potentially minimizing the need for systemic opioids and their associated adverse effects. Several challenges and nuances remain, including the role of regional anesthesia in preventing delirium and the need for comparative studies between different types of nerve blocks. Furthermore, the potential role of nerve catheters in addressing prolonged waiting times until surgery warrants further investigation. Conclusion: Peripheral nerve blocks are an important asset in the preoperative pain management of hip fractures in geriatric patients, necessitating their further integration into early trauma patient care, especially in the emergency department setting.