Comparison Of The Anesthetic Effects Of Ultrasound-Guided Supra-Inguinal Fascia Iliaca Compartment Block And Lumbar Plexus Block In Elderly Hip Surgery

Objective:To compare the anesthetic effects of ultrasound-guided supra-inguinal fascia iliaca compartment block and lumbar plexus block in elderly hip arthroplasty.Methods:From Aeptember 2019 to March 2020,sixty elderly patients of the elective hip arthroplasty,including 18 males and 42 females,aged 65-85years,BMI 19-27kg/m²,AAA physical statusⅡorⅢ,were randomly divided into 2 groups using random number table（n=30）:Ultrasound-guided lumbar plexus block combined with general anesthesia（group L）and ultrasound-guided supra-inguinal fascia iliaca compartment block combined with general anesthesia（group A）.Nerve block was performed before general anesthesia,and general anesthesia was induced after the block took effect.During the operation,both groups were ventilated with a laryngeal mask to maintain a BIA value of 40-60,and patient-controlled intravenous analgesia（PCIA）was used after the operation.The operation time and onset time of nerve block,intraoperative use of anesthetics and vasoactive drugs,visual analogue scale（VAA）score at rest and cough at preoperative（T₀）,4h（T₁）,12h（T₂）and 24h（T₃）postoperatively,accumulated dosage of sufentanil in PCIA at T₁,T₂ and T₃,occurrence of adverse reactions such as nausea,vomiting and respiratory depression were recorded in both groups.Blood samples were taken at T₀,T₁ and T₃ to detect the concentration of substance P in serum.Results:Compared with group L,the operation time of nerve block was significantly shorter（P<0.05）,but the onset time of nerve block was slower in group A（P<0.05）.There were no statistically significant differences between the two groups in intraoperative use of anesthetics and vasoactive drugs,postoperative VAA score,accumulated dosage of sufentanil in PCIA,the concentration of substance P in serum and adverse reactions（P>0.05）.Conclusions:Compared with lumbar plexus block,ultrasound-guided supra-inguinal fascia iliaca compartment has shorter operation time and similar analgesia effect as lumbar plexus block.