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| Application of ultrasound-guided fascia iliaca block combined with lumbar anesthesia in closed reduction and internal fixation for intertrochanteric fractures in elderly patients |
| ZHU Juan, MA Peng, JIANG Peng |
(Department of Anesthesiology, the Affiliated Hospital of Jiangsu University, Zhenjiang Jiangsu 212001, China)
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Abstract ［Abstract］Objective： To investigate the effect of ultrasound-guided supra-inguinal fascia iliaca block combined with lumbar anesthesia on closed reduction and internal fixation for intertrochanteric fractures in elderly patients. Methods： From September 2019 to September 2021, 60 elderly patients with intertrochanteric fracture who received closed reduction of proximal femoral anti-rotation intramedullary nail fixation in our hospital were enrolled and randomly divided into observation group(ultrasoundguided fascia iliaca block combined with lumbar anesthesia, 30 cases) and control group(lumbar anesthesia alone, 30 cases).General conditions, hemodynamic indexes (mean arterial pressure and heart rate), inflammatory cytokine (CRP and IL-6), visual analogue scale(VAS), postoperative intensification of analgesia and incidence of anesthesia related complications in 2 groups were recorded. Results： The average arterial pressure and heart rate of the observation group were lower than those of the control group in the position of lumbar anesthesia (both P<0.05). The levels of CRP and IL-6 of 1d after operation in both groups were higher than that before operation (P<0.05), while the levels of CRP and IL-6 of 1d after operation in the observation group was lower than those in the control group (both P<0.05).VAS of the observation group at lumbar anesthesia position, 12 h, 24 h and 48 h postoperation were significantly lower than those of the control group(both P<0.05). The time of the first postoperative intensive analgesia in the observation group was significantly longer than that in the control group (P<0.05), and the utilization rate of postoperative intensive analgesic drugs in the observation group was significantly lower than that in the control group(P<0.05).There was no significant difference in the incidence of anesthesia related complications between the two groups (P>0.05).Conclusion：Ultrasound-guided suprainguinal fascia iliaca block combined with lumbar anesthesia for closed reduction and internal fixation in elderly patients with intertrochanteric fracture could reduce pain during lumbar anesthesia position, stabilize perioperative vital signs, reduce inflammatory cytokine, provide effective postoperation analgesia, and do not increase anaesthesia related adverse reactions.
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Received: 12 January 2022
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