Impacts of Preoperative Femoral Nerve Block on Postoperative Outcomes for Hip Fracture: A Systematic Review and Meta-Analysis .

Preoperative femoral nerve block (PFNB) is increasingly used to manage pain in older adults undergoing hip fracture surgery. Across seven randomized trials—most conducted in older adults—PFNB appeared safe, with no increase in postoperative delirium. Among the postoperative outcomes examined, only pain at 24 hours showed a clear advantage for PFNB, though the supporting evidence was low in quality. Other outcomes, including opioid use and hospital stay, were similar to control groups, and subgroup results did not show meaningful differences between continuous and single-dose PFNB. With small sample sizes and considerable variation in control treatments, uncertainty remains high, and more rigorous trials are needed to clarify the true benefits of PFNB in the postoperative setting.