不同浓度罗哌卡因行髋关节囊周围神经阻滞缓解老年股骨粗隆间骨折患者术前疼痛的效果探讨OACSTPCD

Objective To explore the efficacy and safety of different ropivacaine ultrasound-guided hip pericap-sular nerve block concentrations in relieving anesthesia preposition pain in elderly patients with intertrochanteric femoral fractures.Methods Sixty elderly patients with femoral intertrochanteric fracture treated with intravertebral anesthesia and proximal femoral nail antirotation at the Third People's Hospital of Yancheng City from March 2022 to March 2023 were selected.According to the concentration of ropivacaine,they were divided into three groups:0.2％ropivacaine 20 mL group(Group L),0.375％ropivacaine 20 mL group(Group M),0.75％ropivacaine 20 mL group(Group H),20 cases in each group.Ultrasound-guided nerve block before the change of the position of intravertebral anesthesia in all patients.Static and dynamic(passive straight leg lift and adduction)visual analog scale(VAS)scores were recorded be-fore nerve block(T0),5 min(T1),10 min(T2),15 min(T3),20 min(T4)after nerve block;the VAS score was recor-ded when the position was placed.The position quality score,the number of remedied analgesia,patient satisfaction,mus-cle strength grading of quadriceps femoris 6 h after surgery and the occurrence of adverse reactions were recorded.Re-sults The static VAS scores of Group H at T2 and T3 were lower than those of Group L(P＜0.05).At T1,T2,and T3,the VAS scores of the passive straight leg lift by 15 degrees of Group H was lower than that of Group L and Group M(P＜0.05).At T4,the VAS scores of the passive straight leg lift by 15 degrees of Group M and Group H were lower than that of Group L(P＜0.05).At T2 and T3,the VAS scores of adduction of Group H was lower than that in Group M and Group L(P＜0.05).At T4,the VAS scores of adduction of Group M and Group H was lower than that of Group L(P＜0.05).The static and dynamic VAS scores in each group at different detection time points have significant differences(P＜0.05).The VAS scores of the intrathecal anesthesia position of Group M and Group H was lower than that of Group L(P＜0.05).The position quality scores of Group M and Group H was better than those of Group L(P＜0.05).The femoral quadriceps muscle strength graded of Group L 6 hours after surgery was better than Group H(P＜0.05).Conclusions 0.375％ropivacaine PENG block alleviates the pain of position placement in the spinal canal of patients with femoral intertrochanteric fractures,improves the quality of position placement and patient satisfaction,with less im-pact on femoral quadriceps muscle strength and less adverse reactions.