Objective To compare the sedative and analgesic effects of ropivacaine and ropivacaine combined with dexmedetomidine on the stability of vital signs and stress response in patients with hip fracture.Methods Using a random number table method,102 patients who were admitted to Luoyang Orthopaedic-Traumatological Hospital of Henan Province/Henan Provincial orthopedic Hospital from February 2020 to February 2023 and scheduled for hip fracture internal fixation were divided into group A and group B,with 51 cases in each group.Group A received femoral nerve block with 3.75 g·L-1 ropivacaine,while group B received femoral nerve block with 3.75 g·L-1 ropivacaine combined with dexmedetomidine.The surgical conditions(intraoperative blood loss,operation time and hospital stay)were compared between the two groups.Taking the time points of pre-operative(T0)and post-operative positioning(T,)as the time nodes,the levels of vital signs indicators[heart rate(HR),mean arterial pressure(MAP)]and visual analog scale(VAS)were compared between the two groups.The scores of observer's assessment of alert/sedation scale(OAA/S)were compared between the two groups.Taking T0 and 24 hours after surgery(T2)as the time nodes,the levels of stress factors[norepinephrine(NE),epinephrine(E),cortisol(Cor)]were compared between the two groups.Results The length of hospital stay in group B was less than that in group A(P＜0.05).The HR,MAP levels and VAS score in group B were lower than those in group A at T1,while the OAA/S score was higher than that in group A at T,(P＜0.05).Compared with the group A,the NE,E and Cor levels in group B were lower at T2(P＜0.05).The total incidence of adverse reactions between group A and group B had no significantly different(P＞0.05).Conclusion The use of ropivacaine combined with dexmedetomidine for femoral nerve block during hip fracture surgery can enhance sedation and analgesia,stabilize hemodynamic levels,reduce stress response,and ensure safety.
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