Application of ultrasound-guided fascia iliaca compartment block with ropivacaine alone and ropivacaine combined with dexmedetomidine in anesthesia of elderly patients with proximal femoral fracture
Objective To observe the application effects of ultrasound-guided fascia iliaca compartment block(FICB)with ropivacaine alone and ropivacaine combined with dexmedetomidine(Dex)in anesthesia of elderly patients with proximal femoral fracture.Methods The clinical data of 105 elderly patients who underwent proximal femoral fracture surgery in Tradi-tional Chinese Medicine Hospital of Bozhou City from March 2020 to November 2023 were retrospectively analyzed.According to different perioperative analgesia methods,patients were divided into combination group(n=55)and ropivacaine group(n=50).Both groups underwent FICB under ultrasound guidance.Patients in the combination group were injected with a mixture of Dex(1 μg/kg)and 0.375％ropivacaine(30 mL),while patients in the ropivacaine group were only given 0.375％ropiv-acaine(30 mL).After surgery,all patients were given sufentanil for patient-controlled intravenous analgesia(PCIA).The in-traoperative and perioperative indexes(block onset time,block disappearance time,first press time and cumulative press num-ber of the analgesic pump),sufentanil dosage,analgesic effect[the scores of Visual Analogue Scale(VAS)under rest state at T0(before block),T1(before anesthesia induction)and T2(1 h after surgery),and VAS scores under motion state at T3(12 h after surgery),T4(24 h after surgery)and T5(48 h after surgery)],sleep quality[Leeds Sleep Evaluation Question-naire(LSEQ)]were compared between the two groups.Hemodynamic indicators[heart rate(HR),mean arterial pressure(MAP)].Results The block onset time and cumulative press number in the combination group were shorter or less than those in the ropivacaine group,and the block disappearance time and first press time of analgesic pump were longer than those in the ropivacaine group(all P＜0.05).The sufentanil dosage in the combination group was lower than that in the ropivacaine group(P＜0.05).There were significant differences in VAS scores under rest state in terms of inter-group dimension,time points di-mension and interaction dimension(P＜0.05).The VAS scores under rest state at T1-T2 in the combination group were lower than those in the ropivacaine group(P＜0.05).There were significant differences in VAS scores under motion state in terms of inter-group dimension and time points dimension(P＜0.05),but there was no difference in terms of interaction dimension(P＞0.05).The VAS scores under motion state at T3-T4 in the combination group were lower than those in the ropivacaine group(P＜0.05).The proportion of high-quality sleep in combination group was higher than that in ropivacatine group(90.00 vs 72.00％,P＜0.05).There was no significant difference in HR between the two groups at any time point(P＞0.05).There were significant differences in MAP in terms of time points dimension and interaction dimension(P＜0.05).MAP level at T1 in the combination group was lower than that in the ropivacaine group(P＜0.05).Conclusion Ultrasound-guided Dex combined with ropivacaine for FICB is beneficial to reduce intraoperative use of opioids and improve sleep quality in elderly patients with proximal femoral fracture.It has certain clinical application value.
万方数据
维普
