Clinical observation of ultrasound-guided fascia iliaca compartment block for elderly patients with hip fracture surgery
Objective To explore the clinical effect of ultrasound-guided fascia iliaca compartment block(FICB)for elderly patients with hip fracture surgery.Methods Totally 96 elderly patients with hip fractures in Kaifeng Peoples Hospital from March 2021 to June 2023 were selected as the research subjects.According to the simple random method,they were classified into observation group(48 cases)and control group(48 cases).Both groups were given intraspinal anesthesia,and the observation group was given midazolam and dezocine for sedation and analgesia before intraspinal an-esthesia and then underwent ultrasound-guided FICB,while the control group was treated with midazolam and dezocine before intraspinal anesthesia and received patient-controlled analgesia(PC A)after surgery.The peri-anesthesia he-modynamic fluctuations,analgesia[visual analogue scale(VAS)],postoperative remedial analgesia status,stress re-sponse indicators[norepinephrine(NE),cortisol(Cor),angiotensin Ⅱ(Ang Ⅱ)]at 1 day before surgery and at 6 hours after surgery and adverse reactions were compared between the two groups.Results There were statistically sig-nificant differences in HR and MAP from the aspects of between-group(P＜0.05).The HR and MAP revealed statis-tical differences between the two groups at T1,T2 and T3(P＜0.05).The VAS score in observation group at 2,6 and 24 hours after surgery was significantly lower(P＜0.05).The number of PCA and the number of effective PCA in obser-vation group were significantly less than those in control group within 24 hours after surgery(P＜0.05),and the first use time of analgesia pump was significantly longer compared to control group(P＜0.05).Compared with before surgery,the levels of NE,Cor and Ang Ⅱ were significantly increased in the two groups at 6 hours after surgery(P＜0.05),and the levels in observation group were significantly lower after surgery(P＜0.05).The adverse reactions between the two groups were not statistically different(P＞0.05).Conclusion Ultrasound-guided FICB can effectively relieve the pe-ri-anesthesia pain,reduce the hemodynamic fluctuations,and effectively relieve the postoperative stress response in elderly patients with hip fracture surgery.It has high safety and can be promoted for clinical use.
Fascia iliaca compartment blockHip fracturesHemodynamicsPostoperative analgesiaCognitive function
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