The Perioperative Management of the Hip Fracture Patient

Purpose of Review: As much of the population continues to live to advanced age, the burden of hip fractures on healthcare systems is expected to increase. This review provides an evidence-based update on the perioperative management of hip fracture patients. It also tries to answer if we can best improve the perioperative outcome of these patients through anesthesia and pain management. Recent Findings: The review did not find that a particular type of anesthesia or pain management is better than others in terms of overall morbidity and mortality. That gives the anesthesiologists the freedom to individualize the anesthetic based on the patient’s needs. Summary: A comprehensive approach that includes preparative optimization, pain management, surgical correction within 48 h, and postoperative care that specifically considers mitigating factors that might worsen cognitive function is recommended. The use of non-opioid analgesia, including nerve blocks, can mitigate delirium. Further research is needed to investigate anesthesia-related outcomes like intraoperative, hypotension, manipulating the airway, the use of opioids, and the economics of the anesthetic techniques.