The Comparative Efficacy of Scheduled to As-Needed Pain Treatments in Patients Hospitalized for Hip Fracture

Abstract

Background

Pain management of patient with hip fracture is important for the wellbeing of the patients and for early mobilization and rehabilitation in these patients may be treated on a scheduled pain control protocol or receive their pain medication according to their need and demand(PRN),

Purpose we retrospectively compared scheduled with as-needed analgesic dosing in patients post hip fracture surgery. We compared a) resting and dynamic pain intensity, b) patient mobility after operation, and c) functional end points.

Methods retrospective cohort study was conducted on 99 patients over the age of 65 who had undergone hip fracture surgery at our hospital. The groups were formed as follows: the first 61 patients were treated ( with scheduled analgesic treatment 4 times a day during their hospitalization) whereas the 38 following were the control group( treatment according to the PRN method We compared the resting and dynamic pain intensity, mobility and functional performance of the 2 groups.

Results As expected, the control group consumed less analgesics than the intervention group. However, the control group reported an increase in postoperative resting and dynamic pain intensity as compared to the intervention group with the younger patients ( below 80) reporting increased pain as compared to the older patients. A positive correlation was seen between functional outcome and analgesic consumption in the control group. The scheduled treatment group achieved both higher functional performance and improved emotional stability than the control group. No difference was seen in the survival rate between the 2 groups 6 months after the operations.

Conclusions This study shows that a scheduled analgesic treatment leads to a decrease in pain intensity and improved functional and emotional outcomes in elderly patients after undergoing hip fracture surgery.