Anesthetic effect of dexmedetomidine combined with pericapsular nerve group block for hip arthroplasty in the elderly
Objective To investigate the anesthetic effect of dexmedetomidine combined with ropivacaine nerve block for direct anterior approach for total hip arthroplasty(DAA-THA)in the elderly,and to compare the analgesic effect and rapid recovery from pericapsular nerve group block(PENGB)versus supra-inguinal fascia iliaca compartment block(S-FICB).Methods A total of 90 patients with an elective surgery of unilateral total hip arthroplasty in Lu'an Hospital of Anhui Medical University from February 2022 to October 2022 were selected.They were divided into three groups using a randomized numerical table method:group A(ropivacaine use for S-FICB,n=30),group B(ropivacaine use for PENGB,n=30),and group C(dexmedetomidine combined with ropivacaine for PENGB,n=30).The Visual Analogue Scale(VAS)scores inrest at the time points of admission(T0),immediately before positioning(T1),and at the time of positioning(T2),and the VAS scores at 15°of hip lifting at 6h(T3),12h(T4),24h(T5),and 48h(T6)after the nerve block were recorded.The Ramsay Sedation Scale(RASS)score at T3 and T6,muscle strength of the quadriceps at T3,operation time and onset time of nerve block,patients'satisfaction with analgesia,intraoperative hemodynamic indicators,incidence of adverse effects,time of the first postoperative off-bed activities,and postoperative length of stay were recorded.Results Muscle strength of the quadriceps at T3 was significantly greater in group B and C than that of group A(P＜0.01).The RASS scores at T3-T6 were significantly higher in group C than those of group A and B(P＜0.05).The VAS scores at T2 were significantly lower in group B and C than those of group A(P＜0.05).The VAS scores at T4-T6 in group C were significantly lower than those of group A and group B(P＜0.01).The operation time was significantly shorter in group B and C than that of group A(P＜0.05).The heart rate at 30min of anesthesia was significantly less in group C than that of group A and group B(P＜0.05).Conclusion PENGB procedure requires short time,fast onset of action,and preserves the motor function of the quadriceps muscle.Dexmedetomidine,as an adjuvant combined with ropivacaine for PENGB can effectively prolong the duration of analgesia and provide good postoperative sedation and analgesia without obvious adverse reactions,which is conducive to the early recovery of patients after surgery.
hip arthroplastypericapsular nerve group blockdexmedetomidinesupra-inguinal fascia iliaca compartment blockanalgesiahip fracture
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维普
