Circumference Of Proximal Femoral Fractures In Elderly Efficacy Of Perioperative Pain Control

Proximal femur generally refers to5cm, the proximal part of the femur underthe lesser trochanter of the femur, but only within a fixed International Societyunder the scope of the lesser trochanter of the femur nearly edge plane is defined asthe proximal femur. Proximal femoral fractures are common and frequentlyoccurring clinical orthopedics, including femoral neck fractures, intertrochantericfractures, subtrochanteric fractures of femoral neck fracture [1], more common inthe elderly. Proximal femoral fractures are more common in the1990s an estimated1.7million cases worldwide of such fractures occur every year, is one of thedifficulties in clinical orthopedic trauma. In recent years, with the acceleration of theaging process of our society, the number of patients with proximal femoral fracturestrend of increasing year by year, a serious threat to the quality of life of elderlypatients. For the older age groups in terms of pre-fracture often poor generalcondition, often associated with other organ or system disorders, and treatment offractures easy to induce or aggravate existing complications of the disease,increasing the complexity and risks of treatment; where pain Wai-operativecomplications, development plays an important role. Pain is an important factor ininducing ischemic heart and cerebrovascular disease symptoms and, therefore, forthe effective control of perioperative pain in elderly patients with symptoms, is veryimportant.Objective: To compare the program with a simple multi-modal analgesiapatient-controlled intravenous analgesia(PCIA) for proximal femoral fractures inelderly patients with perioperative analgesic effect. Methods: A total of around1August2010, collected141cases of proximalfemur fractures in elderly patients, male60cases, female81cases; average74.4years of age. Multimodal analgesia group with preoperative non-steroidal analgesicmedication, preemptive analgesia day of surgery, postoperative analgesia pump orother forms of parenteral injection drug use, after three days, instead of oralnon-steroidal body analgesic drugs for10days. Control group using traditionalperioperative analgesic pain as rescue measures, mainly in patients with intravenousanalgesia pump until after48h. Two sets of records under resting pain visual analogscale (VAS), perioperative record1week of sleep, and the occurrence of mentaldisorders, duration, mainly for perioperative delirium incidence, severity andduration of the evaluation.Results: After one day, multi-modal pain VAS score was significantly lowerthan the control group, the sleep time was significantly longer than the controlgroup (P <0.05); perioperative delirium incidence of12.77%,20.83%lower than inthe control group (P <0.05); delirium severity of the initial DRS score17.23±3.63,lower than the control group,21.58±4.07(P <0.05); delirium sustained averagetime2.19±1.72, control group3.86±1.51(P <0.05).Conclusion: The proximal femoral fractures in elderly patients with activeperioperative pain control can significantly reduce pain and improve sleep quality ofpatients and reduce the incidence of delirium caused by trauma, reduce the severityof delirium and shorten the duration of delirium, multimodal analgesia program is asafe, effective treatment measures to good effect.