Effects of Intraoperative Local Pain Injections on Early Function & Patient-Reported Outcomes .
Effects of Intraoperative Local Pain Cocktail Injections on Early Function and Patient-Reported Outcomes: A Randomized Controlled Trial.
J Orthop Trauma . 2023 Sep 1;37(9):433-439.One hundred eighty-four patients with OTA/AO 31A1-3 and 31B1-3 hip fractures undergoing surgical fixation were randomized to receive either a multimodal intraoperative pain cocktail injection (bupivacaine, morphine sulfate, ketorolac; n=75) or no injection (n=109). The primary outcome was postoperative pain (VAS score). Secondary outcomes included narcotic usage (MME), ambulation distance, complications, and patient-reported outcomes via the APS-POQ and SMFA, assessed up to 6 weeks postoperatively. Overall, the results showed significantly lower pain and narcotic use on POD 0, greater ambulation on POD 2 and 3, fewer major complications, and better 6-week patient-reported outcomes in the HiFI group. These findings suggest that intraoperative HiFI injections improve early pain management and enhance short-term functional recovery in hip fracture surgery patients.
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