Application Of Ultrasound-guided Iliac Fascial Space Block Combined With Superficial General Anesthesia In Hip Arthroplasty In Elderly Patients

Objective: To investigate the anesthetic effect of fascia iliaca compartment block combined with superficial general anesthesia during hip replacement in elderly patients and its effect on postoperative recovery,so as to provide a new feasible anesthetic method for enhanced recovery after surgery in elderly patients undergoing hip replacement.Methods: Sixty elderly patients aged 65~102 years old with ASAII~ level III who underwent elective hip replacement under general anesthesia in our hospital from June2018 to June 2019 were selected.They were randomly divided into two groups,30 cases in each group,namely,the group with general anesthesia alone(group C,n=30)and the group with nerve block combined with superficial general anesthesia(group F,n=30).Group C underwent surgery under conventional general anesthesia.Group F underwent ultrasound-guided iliac fascia clearance block before surgery.After the block was completed,superficial general anesthesia was applied.Changes in mean arterial pressure and heart rate at each time point(T0),after changing body position(T1),5min(T2)after skin resection,after reaming cavity(T3),immediately after tracheal extubation(T4),as well as changes in blood glucose and lactic acid before,after and 24 h after surgery were recorded.VAS scores and adverse reactions were observed and recorded at 6h,12 h and24h after surgery.Hip function scores were compared between the two groups in terms of time of discontinuation,length of stay,and preoperative and discharge time.Results: There was no statistically significant difference in preoperative general conditions between the two groups(P > 0.05).Compared with group C,the hemodynamics of patients in group F were more stable at different time points during the operation,and the MAP and HR of t1-t4 points in group C were significantly lower than that in group C,and the difference was significant compared with that in group C(P < 0.05).Perioperative blood glucose and lactate levels in F group were lower than those in C group(P < 0.05).The VAS score and the incidence of postoperative adverse reactions at each time point were significantly higher in group C than in group F,with statistically significant differences(P < 0.05).The activity time and length of stay in the F group were lower than that in the C group(P < 0.05).The hip function score of group F at discharge was superior to that of group C(P < 0.05).Conclusion:Combined with ultrasonic-guided iliac fascia block and superficial general anesthesia for hip arthroplasty,it can stabilize the hemodynamics of patients,reduce the stress response of the body,and reduce the incidence of adverse reactions.Compared with traditional general anesthesia,it is safer and more reliable,which is conducive to accelerating the rapid recovery of patients and achieving the enhanced recovery after surgery model.