Scheduled Analgesic Regimen Improves Rehabilitation After Hip Fracture Surgery
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Clin Orthop Relat Res (2013) 471:2349–2360 DOI 10.1007/s11999-013-2927-5
A Publication of The Association of Bone and Joint Surgeons®
CLINICAL RESEARCH
Scheduled Analgesic Regimen Improves Rehabilitation After Hip Fracture Surgery Raymond Ping-Hong Chin FRCS, FHKAM, FHKCOS, Chin-Hung Ho FRCSE (Orth), FHKAM, FHKCOS, Lydia Po-Chee Cheung MSN
Received: 27 October 2012 / Accepted: 8 March 2013 / Published online: 30 March 2013 Ó The Author(s) 2013. This article is published with open access at Springerlink.com
Abstract Background Postoperative pain often is the limiting factor in the rehabilitation of patients after hip fracture surgery. Questions/purposes We compared an approach using scheduled analgesic dosing with as-needed analgesic dosing in patients after hip fracture surgery, to compare these approaches in terms of (1) resting and dynamic pain intensity, (2) postoperative patient mobility, and (3) functional end points.
Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request. Clinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA approval status, of any drug or device before clinical use. Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained. This work was performed at Queen Elizabeth Hospital (Hong Kong, People’s Republic of China) and Kowloon Hospital (Hong Kong, People’s Republic of China). R. P.-H. Chin, C.-H. Ho, L. P.-C. Cheung (&) Department of Orthopaedics and Traumatology, Queen Elizabeth Hospital, Hospital Authority, 3/Floor, M Block, 30 Gascoigne Road, Jordon, Kowloon, Hong Kong, China e-mail: [email protected] R. P.-H. Chin, C.-H. Ho, L. P.-C. Cheung Orthopaedic Rehabilitation Centre, Kowloon Hospital, Hospital Authority, Hong Kong, China
Methods We conducted a prospective cohort study of 400 patients who underwent surgical treatment of hip fractures at our hospital. The groups were formed sequentially, such that the first 200 patients formed the intervention group (treated with scheduled analgesic intake for the first 3 weeks after surgery), and the next 200 patients were the control group (treated using a protocol of analgesic administration on request). Resting and dynamic pain intensity, mobility, and functional performance were compared between the two analgesic protocols. Results As expected, analgesic consumption was lower in the cont
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