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Abstract

Application of Non-Opioids under the Concept of Enhanced Recovery after Surgery under Ultrasound-Guided Iliac Fascia Nerve Block Anesthesia in Elderly Patients with Hip Fracture Surgery

Author(s): Chen Zhang and Qingqing Shi*
Department of Anesthesiology, Taizhou Traditional Chinese Medicine Hospital, 1Department of Anesthesiology, Taizhou Municipal Hospital, Taizhou, Zhejiang Province 318000, China

Correspondence Address:
Qingqing Shi, Department of Anesthesiology, Taizhou Municipal Hospital, Taizhou, Zhejiang Province 318000, China, E-mail: shiqq0516@163.com


To discuss the application of enhanced recovery after surgery concept in ultrasound-guided iliac fascia nerve block in elderly hip fracture surgery patients and its effect on traumatic stress in patients during perioperative period. Selected 100 elderly patients undergoing hip fracture surgery in our hospital from January 2021 to September 2021. Divided 50 patients of non-opioid ultrasound-guided iliac fascia nerve block anesthesia into observation group and the other 50 patients of opioid (sufentanil) anesthesia into control group. Compared perioperative heart rate and mean arterial pressure indexes of both groups; compared visual analog scale, sedation-agitation scale and mini-mental state examination scores of patients on the 2 d after surgery; compared cortisol, C-reactive protein and interleukin-6 levels in serum of both groups. Compared Harris hip function score, perioperative complications (pressure sores, lower extremity venous thrombosis, lower limbs swelling, lung infection), length of hospital stay and hospitalization expenses of both groups at 3 mo after surgery. Observation group had lower mean arterial pressure and heart rate during spinal canal intubation than control group, which possessed statistical significance (p<0.05). On the 1 d after surgery, observation group had higher visual analog scale score than control group (p>0.05), but had remarkably lower sedation-agitation scale score than control group (p<0.05), and had remarkably higher mini-mental state examination score than control group (p<0.05). At 3 mo after surgery, observation group had higher affected hip joint Harris score than control group (p<0.05), and postoperative complications rate in observation group (8 %) was remarkably lower than control group (16 %), observation group had remarkably lower hospitalization expenses and length of stay than control group, so the divergence possessed statistical significance (p<0.05). Under the concept of enhanced recovery after surgery, nonopioids under ultrasound-guided iliac fascia nerve block anesthesia can better improve hip joint function, reduce postoperative cognitive dysfunction and reduce postoperative complications in geriatric hip fracture surgery. It can remarkably shorten the length of hospitalization and hospitalization expenses. Compared with traditional opioid spinal anesthesia, it can remarkably accelerate the recovery of patients after surgery.

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