Effects of pengb combined with spinal anesthesia on postoperative analgesia and serum inflammatory factors in patients undergoing total hip arthroplasty
Objective To investigate the effect of peripheral nerve block(PENGB)on postoperative analgesia in patients undergoing total hip arthroplasty(THA).Methods Ninety-two patients after TH A were ran-domly divided into control group and observation group,46 cases in each.Patients in control group were giv-en fascia iliaca compartment block(FICB)combined with spinal anesthesia,and patients in observation group were given PENGB combined with spinal anesthesia.The pain scores of two groups were recorded at 4h,8h,24h and 48h after operation.The quadriceps strength was evaluated at 4h,8h,24h and 48h after operation.The first ambulation time,walking distance and postoperative hospital stay of two groups were recorded.Se-rum levels of IL-6 and TNF-α were measured before and 1 day after surgery.Results Compared with control group,VAS score of active state in observation group decreased significantly at 4h,8h and 24h after opera-tion(P＜0.05).There were no significant differences in resting-state pain scores between two groups at each time point(P＞0.05).The results of pressing times of analgesic pump showed that the number of pressing times in 48 hours in observation group was significantly lower than that in control group(P＜0.05),and the requirement for rescue analgesia was significantly reduced(P＜0.05).The muscle strength of quadriceps femoris in observation group increased significantly at 4h,8h and 24h after operation(P＜0.05).The first walking time showed that observation group was significantly earlier after surgery(P＜0.05),and the first walk distance increased significantly(P＜0.05).Postoperative hospital stay in observation group was shorter than that in control group(P＜0.05).Compared with pre-operation,the serum IL-6 and TNF-α levels of two groups were significantly increased on the first day after operation(P＜0.05).Compared with control group,the above inflammatory indexes in observation group were significantly decreased(P＜0.05).Conclusion PENGB combined with intraspinal anesthesia for THA can improve postoperative analgesia,relieve pain dur-ing postoperative activities,improve muscle strength of lower limbs,inhibit inflammatory reaction,and pro-mote early recovery of patients.
Total hip arthroplastyNerve blockFascia iliaca compartment blockPeripheral nerve block of hip capsulePostoperative painInflammatory response
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