The influence of vitamin C on postoperative pain in patients with trochanteric femur fracture
Pain control in patients after hip fracture surgery.
This prospective, single-blinded, randomized, placebo-controlled study will include 70 patients who will be surgically treated at the Department of Orthopedics and Traumatology, Cantonal Hospital Zenica, Bosnia and Herzegovina. After checking the inclusion and exclusion criteria, patients will be randomly assigned to either the vitamin C group or the control group using a random number generator (www.randomizer.org), with each group comprising 35 patients. Participants will be blinded to group allocation as well as to the type of drug administration. Patients in the vitamin C group will receive 1 g of oral vitamin C daily in the form of two 500 mg vitamin C tablets in morning and evening doses for 40 days postoperatively. Patients in the control group will receive placebo tablets with the same size, color and shape as patients in the vitamin C group, two times daily for 40 days postoperatively. Compliance will be checked through specially designed medication log sheets during postoperative follow-ups, with a satisfactory level of 80%. All surgeries will be performed under general anesthesia. A short cephalomedullary nail of the third generation will be used for osteosynthesis in all cases. First-generation cephalosporin will be used for antibiotic prophylaxis, and enoxaparin at a dose of 40 mg once daily, administered subcutaneously, will be used for thromboprophylaxis for 35 days postoperatively. Baseline characteristics of patients will be noted in each group. On the second postoperative day, the drain will be removed and a control X-ray will be taken. Further X-ray controls will be performed at 6 and 12 weeks after the operation. Postoperative consultations will be performed at 2, 6 and 12 weeks when complications and side effects of vitamin C will be noted. Pain severity will be assessed using the 10-cm Visual Analogue Scale (VAS), ranging from 0 (“no pain”) to 10 (“worst pain possible”), on the second postoperative day, and at 2, 6 and 12 weeks postoperatively
1. AO-classified trochanteric fractures (types 31.A1, A2, A3) 2. Age ≥18 years 3. Injury within two weeks 4. Approval to participate in the study
1. Prior hip surgery 2. Polytrauma 3. Diabetes 4. Previous limb amputation 5. Renal insufficiency 6. Cardiorespiratory compromise 7. Coagulation disorders 8. Malignancy 9. Pathologic fractures 10. Contraindications to surgery 11. Medication allergies 12. Neurological deficits 13. Refusal to participate in the study