Preoperative Analgesia Strategies

The trial introduces a function-based pain assessment focused on clinically meaningful hospital activities—eating while sitting, turning for hygiene care, and transferring for imaging—rather than passive limb elevation. All trial participants receive background multimodal analgesia with intravenous flurbiprofen axetil 50 mg twice daily and a morphine rescue pump with a 30-minute lockout, capped at 60 mg per 24 hours. Continuous nerve blocks provide effective analgesia but can involve catheter misplacement, dislodgement, leakage, pump malfunction, and increased monitoring workload. Traditional movement pain assessment involving passive elevation of the affected limb to 15 degrees can impose unnecessary strain when pain is inadequately controlled. Current clinical guidelines recommend multimodal preoperative analgesia for hip-fracture patients, including regional nerve blocks such as femoral nerve block, fascia iliaca block, and PENG block.