超声引导下腹股沟韧带上髂筋膜间隙阻滞在老年髋部骨折患者围术期镇痛中的应用研究OACSTPCD

Objective Patients with hip fracture are prone to severe pain during perioperative period.Many previous studies focused on postoperative analgesia,but few explored the analgesic effect of iliac fascia space block technique in elderly patients with hip fracture before surgery.This study aims to analyze the application value of ultrasound-guided suprainguinal fascia iliaca compartment block(S-FICB)in perioperative analgesia of elderly patients with hip fractures.Methods A total of 80 elderly patients with hip fracture admitted to Department of Orthopedics,Jinshan Hospital Affiliated to Fudan University from January 2023 to December 2023 were selected and divided into observation group(n=40)and control group(n=40)ac-cording to random number table method.The observation group received S-FICB guided by ultrasound,while the control group received routine analgesia with intravenous injection of parecoxib sodium.Preoperative analgesia was performed in both groups.The pain score(VAS score),Ramsay sedation score,mean arterial pressure(MAP),heart rate(HR),and pulse oxygen sat-uration(SpO2)of the patients were recorded immediately before analgesia(T0),30 min(T1)and 2 h(T2),12 h(T3),24 h(T4),and 48 h(T5)after analgesia.Compare the number of additional intravenous injections of parecoxib sodium in the two groups.Compare the number of adverse reactions such as nausea,vomiting,sedation,urinary retention,hypotension,as well as preoperative satisfaction and length of hospital stay in the two groups.Results Except for the T0 time point,the VAS scores of the control group were higher than those of the observation group at all other time points(P＜0.05).At T2 and T3 time points,the Ramsay sedation scores of the observation group were higher than those of the control group(P＜0.05).There was no statistically significant difference in MAP,HR,and SpO2 between the two groups(all P＞0.05).After analgesic treatment,the observation group had fewer cases of parecoxib sodium supplementation than the control group(P＜0.05).The incidence of nausea and vomiting in the control group was higher than that in the observation group(P＜0.05).The preopera-tive satisfaction of the patients in the observation group was higher than that in the control group(P＜0.05).There was no sig-nificant difference in the length of hospital stay between the two groups(P＞0.05).Conclusion Ultrasound-guided S-FICB has significant analgesic effects in elderly patients with hip fractures during the perioperative period.It can effectively relieve preoperative pain,reduce the use of systemic analgesics,reduce the incidence of nausea and vomiting,and improve patients'preoperative satisfaction.