Caring for a Patient with Inoperable Hip Fracture

Area of Science:

• Geriatric Medicine
• Palliative Care
• Pain Management

Background:

• Hip fractures present significant pain management challenges, especially in elderly patients with comorbidities who are not surgical candidates.
• Traditional opioid analgesia can lead to sedation and inadequate pain control in this population.

Purpose of the Study:

• To evaluate the efficacy of patient-controlled analgesia (PCA) for managing severe incident pain in a non-operative geriatric palliative care patient with a hip fracture.

Main Methods:

• A case study of an older male patient with multiple comorbidities and a hip fracture managed non-operatively.
• Utilized intravenous fentanyl via patient-controlled analgesia (PCA) for pain management after standard opioids proved insufficient and caused sedation.

Main Results:

• Patient-controlled analgesia (PCA) with intravenous fentanyl provided effective, short-acting pain relief.
• The patient remained alert and able to participate in care while receiving PCA, unlike with standard opioids.

Conclusions:

• Patient-controlled analgesia (PCA) is a viable and practical option for managing incident pain in select palliative care patients with hip fractures who are not fit for surgery.
• This approach can improve pain control and patient engagement in care within geriatric palliative settings.