Femoral nerve blockade in hip fracture patients

INTERVENTION: Patients are randomised to femoral nerve blockade or the regular use of opioids. Both groups will receive 1 g of paracetamol 4 times/day. The patients in the intervention group will receive a femoral nerve blockade as soon as they arrive at the Orthopaedic Department. If the patients in the intervention group assess pain according to Visual Analogue Scale (VAS) more than 4 then they will be given morphine intravenously (iv) according to the standard protocol (morphine 10 mg/ml, 1 ‐ 5 mg when necessary). Patients in the control group will be given morphine iv according to the standard protocol when they assess pain according to VAS more than 4 but no blockade (morphine 10 mg/ml, 1 ‐ 5 mg when necessary). Post‐operative pain treatment will be given according to the standard protocol in both arms of the study. The total follow‐up of the trial for both arms will end at the time of discharge. CONDITION: Hip fracture ; Injury, Occupational Diseases, Poisoning ; Fracture of femur PRIMARY OUTCOME: 1. Post‐operative delirium, assessed three times a day at the Orthopaedic Department ; 2. Post‐operative complications, such as decubital ulcers, infections, thrombosis, heart failure, assessed three times a day at the Orthopaedic Department; 3. Pain, assessed three times a day at the Orthopaedic Department; ; A cognitive test will be assessed in the ambulance pre‐hospitally and at 24 +/‐ 6 hours post‐operatively. At days three to five a more thorough assessment will be done including delirium, depression, cognitive status, quality of life and more. SECONDARY OUTCOME: 1. Mortality; 2. Orthopaedic recovery, recorded at the time of discharge from the hospital; 3. EQ‐5D; 4. Economics; ; A cognitive test will be assessed in the ambulance pre‐hospitally and at 24 +/‐ 6 hours post‐operatively. At days three to five a more thorough assessment will be done including delirium, depression, cognitive status, quality of life and more. INCLUSION CRITERIA: 1. Both males and females, aged 70 years and above 2. All hip fracture patients admitted to the Orthopaedic Department