Application Effect of Subarachnoid Block Combined with Iliac Fascia Block in Elderly Patients with Hip Fracture Surgery and the Related Factors of Postoperative Delirium
Objective To explore the application effect of subarachnoid block combined with iliac fascia block in elderly patients with hip fracture surgery and the related influencing factors of postoperative delirium.Methods A total of 80 old patients who underwent surgery for hip fractures under subarachnoid block combined with iliac fascia block anesthesia in Xinyang Central Hospital from October 2021 to December 2022 were selected as the observation group,and 80 old patients who underwent surgery for hip fractures under subarachnoid block as the control group.The differences in the onset and maintenance time of motor and sensory nerves,visual analogue scale(VAS),and postoperative delirium between the two groups were observed.Results The onset time of nerve block in the observation group,as well as VAS pain scores at 12 and 24 hours after surgery were lower than those in the control group,and the maintenance time longer than that in the control group(P＜0.05).The incidence of postoperative delirium in the observation group was lower than that in the control group(P=0.007).Patients aged ≥ 80 years,observation group with injury to surgery time ≥ 3 days,underlying diseases≥3,surgery time≥2 hours,albumin ≤ 35 g·L-1,and intraoperative blood loss ≥ 500 mL had a higher incidence of postoperative delirium(P＜0.05).The logistic regression analysis results showed that age,time from injury to surgery,albumin,and intraoperative blood loss were the influencing factors for postoperative delirium in patients(P＞0.05).Conclusion The application of subarachnoid block combined with iliac fascia block anesthesia in elderly patients with hip fractures has a good effect in surgery,with fast onset of nerve block,long maintenance time,mild postoperative pain,and low incidence of postoperative delirium.The occurrence of postoperative delirium is related to the patient's age,time from injury to surgery,albumin,and intraoperative blood loss.
subarachnoid blockiliac fascia block anesthesiahip fracturepostoperative deliriumrisk factors
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