Effect of Rebound Pain on Postoperative Intensive Care Delirium in Patients Undergoing Hip Surgery With Peripheral Nerve Block

Postoperative delirium is a significant and commonly encountered complication in patients undergoing hip surgery, particularly among the elderly. Postoperative delirium is associated with serious consequences, including prolonged intensive care unit stay, increased complication rates, higher mortality risk, and rising healthcare costs.

The incidence of Postoperative delirium after hip fracture surgery has been reported to range between 13% and 55.9%, indicating a substantial clinical burden.

Effective postoperative pain control is critical not only for maintaining quality of life but also for preserving cognitive well-being. In this context, peripheral nerve blocks are frequently used for pain management following hip surgery.

In recent years, the Pericapsular Nerve Group block and the supra-inguinal fascia iliaca block have gained attention as regional anesthesia techniques that provide effective analgesia by targeting the nerve branches innervating the anterior capsule of the hip joint.

Inclusion criteria

• Patients aged 18-80
• ASA I-III risk groups
• Undergoing elective hip surgery

Exclusion criteria

• Preoperative history of delirium, dementia, or major neurological disease
• Present cognitive impairment or severe hearing or visual impairment that could affect pain assessment
• Development of mechanical ventilation requirement in the intensive care unit; Need for bilateral hip surgery
• Failure to provide meaningful analgesia after block application due to surgical pain outside the scope of the block
• Patient's inability to complete the pain diary during postoperative follow-up;
• Urgent hip surgery
• Voluntary failure to give consent or request to withdraw from the study.