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Guidelines outlining current best practice for acute pain management in the elderly now exist, but evidence suggests that practice remains variable and there continues to be scope for improvement. We conducted a narrative review of the literature to examine the challenges of acute pain management in the elderly, and to evaluate evidence for the role of regional nerve blocks for acute pain associated with hip fracture in the elderly. There is consistent evidence that regional nerve blocks can effectively reduce pain associated with hip fracture, providing rapid\u2010onset, site\u2010specific analgesia that is more effective than standard systemic analgesia alone. There is also moderate evidence that nerve blocks may contribute to reduced rates of delirium, and some suggestion of reduced length of inpatient stay, morbidity and mortality, although limited evidence is available. Fascia iliaca blocks are emerging as a block of choice, with evidence they can be safely and rapidly administered under ultrasound guidance in the acute setting, by both trained medical and nursing staff, with good effect. Ideally, comprehensive pain protocols for elderly hip fracture patients are required, that integrate evidence\u2010based fascia iliaca block use, timely and repeated pain assessment, and multidisciplinary orthogeriatric patient care.<\/jats:p>","DOI":"10.1111\/anae.14178","type":"journal-article","created":{"date-parts":[[2017,12,26]],"date-time":"2017-12-26T06:02:42Z","timestamp":1514268162000},"page":"769-783","source":"Crossref","is-referenced-by-count":96,"title":["Regional nerve blockade for early analgesic management of elderly patients with hip fracture \u2013 a narrative review"],"prefix":"10.1111","volume":"73","author":[{"given":"A.","family":"Scurrah","sequence":"first","affiliation":[{"name":"Department of Anaesthetics St Vincent's Hospital Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. T.","family":"Shiner","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation and Pain Medicine St Vincent's Hospital Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. A.","family":"Stevens","sequence":"additional","affiliation":[{"name":"Department of Anaesthetics St Vincent's Hospital Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. G.","family":"Faux","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation and Pain Medicine St Vincent's Hospital Sydney NSW Australia"},{"name":"University of New South Wales Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,12,26]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"Australian and New Zealand Hip Fracture Registry (ANZHFR) Steering Group.Australian and New Zealand guideline for hip fracture care: improving outcomes in hip fracture management of adults.Sydney:Australian and New Zealand Hip Fracture Registry Steering 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