Liposomal Bupivacaine Fascia Iliaca Block for Perioperative Sleep Quality in Elderly Patients With Intertrochanteric Fracture

Older adults with hip fracture often experience severe pain before and after surgery. This pain can cause anxiety and poor sleep, and may increase the risk of postoperative delirium (sudden confusion after surgery). A fascia iliaca compartment block (FICB) is an injection of numbing medicine near the hip nerves that relieves pain, but standard numbing medicines only last about 8 to 12 hours. Liposomal bupivacaine is a long-acting form of a numbing medicine that may relieve pain for up to 72 hours after a single injection. This study tests whether giving an ultrasound-guided FICB with liposomal bupivacaine immediately after hospital admission (before surgery) improves sleep quality, reduces anxiety and pain, lowers the need for opioid pain medicines, and reduces postoperative delirium in patients aged 65 to 80 years undergoing surgery for intertrochanteric hip fracture, compared with a placebo (saline) injection. All participants in both groups receive the same standard pain treatment, including scheduled intravenous dexketoprofen and patient-controlled analgesia after surgery.