Delirium Bibliography

Reference Information

Title

Simplified Pain Management Including Fentanyl TTS in PACU Patients With Hip Fracture Surgery to Improve Patients' Well-Being: A Double-Blind Randomized Trial

Authors

Labmayr, V. Rief, M. Reinbacher, P. Gebauer, D. Smigaj, J. Sandner-Kiesling, A. Papamargaritis, V. Michaeli, K. Bornemann-Cimenti, H. Schittek, G. A.

Year

2024

Journal

J Perianesth Nurs

Abstract

PURPOSE: Adequate pain management is eminently relevant for elderly and more vulnerable patients with hip fractures in the setting of pre and postoperative pain. This study compares postoperative hip fracture patients treated with standard pain management with a variety of medications or an approach with only one option in each medication category (nonopioid: acetaminophen; opioid: fentanyl TTS 12,5 mcg/hour; rescue medication: piritramide) to simplify the treatment algorithm for nurses and improve patient well-being. DESIGN: Double-blind randomized controlled trial. METHODS: The sample was cognitively intact patients (N = 141) with hip fractures in a tertiary university hospital. Administration of fentanyl 12 mcg/hour transdermal therapeutic system was administered by the nurses in the postanesthesia care unit (PACU) to address basal wound pain to improve patient well-being and patient treatment in the PACU for 24 hours to better control for early complications. FINDINGS: Well-being was equally increased in both groups in comparison to our preintervention data from 35.7% to over 60% and did not differ significantly between the intervention and control group. No statistically significant differences in numeric rating scale scores, rescue opioid dosage (piritramide i.v.) or in complications were present. CONCLUSIONS: This one-size-fits-all simplified pain management approach did not improve patient well-being or any other outcome but highlighted the importance of adequate pain management and a sufficient nurse-to-patient ratio.

PMID

PMID: 38085188

Keywords

Humans
Double-Blind Method
*Hip Fractures/surgery/complications
*Fentanyl/administration & dosage
Male
Female
Aged
*Pain Management/methods/statistics & numerical data/standards
*Pain, Postoperative/drug therapy
*Analgesics, Opioid/administration & dosage
Aged, 80 and over
Middle Aged
Acetaminophen/administration & dosage/therapeutic use
Postanesthesia Nursing/methods/standards
Pirinitramide/administration & dosage
Recovery Room/statistics & numerical data
Pacu
analgesia
delirium
hip fracture
pain
well-being

Page(s)

Volume

Issue