The Application Of Fascia Iliaca Compartment Block In Alleviating The Pain Of Patients With Total Hip Arthroplasty Caused By The Lateral Supineposition

Objective: The purpose of this study is to observe the application of fascia iliaca compartment block(FICB)which using of dexmedetomidine(DEX)combined with ropivacaine in alleviating the pain of patients with total hip arthroplasty(THA)caused by the lateral supineposition.Method: In this study,90 THA patients were enrolled in,whose ASA were ?~? levels and age were 40 to 70 years old.According to the randomized table,all patients were divided into three groups(S group,R group and D group,30 patients of every group)randomly,and the anesthesia method was Spinal Anesthesia(SA)in L3-4 clearance.Before SA,ultrasound-guided FICB anesthesia was used to all patients.The S group was used normal saline for FICB,the R group was used ropivacaine for FICB,and the D group was used DEX combined with ropivacaine for FICB.All patients in this study were monitored electrocardiogram(ECG),heart rate(HR),mean arterial pressure(MAP),pulse oxygen saturation(Sp O2)and visual analogue scale(VAS)pain regularly when they entered the operation room,and also mask oxygen-inspiration.Monitored and recorded the values of MAP,HR,Sp O2 and VAS of the patients when they entered the operating room(T0),FICB was used(T1),5min after FICB was used(T2)and 10 min after FICB was used(T3)when SA changed the body postures.Monitored and recorded the operation time,the amount of operative bleeding,anesthesia satisfaction,bradycardia in anesthesia period,hypotension,nausea,emesis,shiver of three groups,respectively.Results: Comparison of generalized characteristics among three groups,there was no significant difference in sex,age,weight,height,operation time,anesthesia operation time and amount of bleeding(P > 0.05 for each).(1)Comparison of haemodynamics changes between R group and S group,the values of blood pressure and heart rate fluctuation was decreased in R group in T3(P < 0.05),and for D group and R group,the values of blood pressure and heart rate fluctuation was decreased in R group in T3(P < 0.05).(2)Comparison of VAS scores: In S group,there was no significant difference in comparison of the change of VAS scores(T0 vs.T1,and T0 vs.T2,P > 0.05 for each),but the VAS scores was increased in T3 than T0(P < 0.05).In D group and R group,there was no significant difference in comparison of the change of VAS scores(T0 vs.T1,P > 0.05 for each),but the VAS scores was decreased in T2 than T0,as well as decreased in T3 than T2(P < 0.05,for each).Comparison of the change of VAS scores between three groups,there was no significant difference in T1(S group vs.R group,and S group vs.D group,P > 0.05 for each),while the VAS scores was decreased in R group and D group in T2 and T3(S group vs.R group,and S group vs.D group,P < 0.05,for each).And compared between R group and D group,VAS scores of D group was lower than R group in T2 and T3(P < 0.05,for each).(3)Comparison of general condition and complications: There was no significant difference in headache,nausea,emesis,hypotension,bradycardia and local anesthetics intoxication(P > 0.05 for each).(4)Comparison in anesthesia satisfaction: The average score of anesthesia satisfaction of D group(87.5 ± 10.6 score)was higher than R group(80.7 ± 11.3 score)and S group(73.7 ± 12.4 score)(P < 0.05).Conclusion: Application of fascia iliaca compartment block under ultrasound-guide can alleviate the pain and change haemodynamics obviously in total hip arthroplasty which caused by changing body postures.Combined dexmedetomidine with ropivacaine were used to fascia iliaca compartment block anesthesia,which has better analgesic effect and higher anesthesia satisfaction than using ropivacaine alone.