Ultrasound-guided pericapsular nerve group block for pain control in elderly patients with hip fractures during posture changing
Objective To evaluate the effect of ultrasound-guided pericapsular nerve group block(PENGB)on analgesic efficiency in elderly patients with hip fractures during lateral position placement before combined spinal-epidural anesthesia by comparing with supra-inguinal fascia iliaca clearance block(S-FICB).Methods A total of 83 patients,including 15 males and 68 females,aged 80 years or older with hip fractures who were scheduled for surgery were selected,with ASA class Ⅲ or Ⅳ.They were randomly divided into the PENGB group(group P,n=41)and the S-FICB group(group S,n=42).Both groups received a single nerve block with 20 ml of 0.4％ropivacaine before combined spinal-epidural anesthesia.The operation time,the numeric rating scale(NRS)scores of resting and moving(passive leg lifting 15°)were recorded before nerve block(T0),5 minutes(T1),10 minutes(T2),15 minutes(T3)after block,and the time of position changing(T4),the number of patients requiring remedial analgesia were evaluated.Additionally,we alos evaluated the incidences of local anesthetic poisoning,misguided into blood vessels,postoperative delirium,hematoma at the puncture site,and infection.Results The resting NRS scores at T2-T4 in group P were lower than those in group S(P＜0.05).The moving NRS scores at T3-T4 in group P were lower than those in group S(P＜0.05).At T4,3 patients(7％)in group P and 11 patients(26％)in group S needed salvage analgesia,respectively(P＜0.05).There was no significant difference in the operation time and the incidence of complications(P＞0.05).Conclusion At the same dose(20 ml of 0.4％ropivacaine),the analgesic effect of PENGB in the lateral position of spinal-epidural anesthesia in elderly patients with hip fracture is better than that of S-FICB,with lower onset time.
万方数据
维普
