| Objective: To observe the effect of different concentrations of ropivacaine on postoperative analgesia,hemodynamics and motor function in elderly patients with hip joint surgery.To compare the clinical application of different concentrations of ropivacaine in combination with general anesthesia.Methods:Sixty elderly patients with hip joint operation under general anesthesia were randomly divided into three groups(A,B,C)with 20 cases in each group.The three groups were combined with general anesthesia under ultrasound.The concentration of ropivacaine in group A was 0.25%,that of ropivacaine in group B was 0.375%,and that of ropivacaine in group C was 0.5%.The three groups were observed Methods: general anesthesia induction,hemodynamic changes during skin cutting and extubation,dosage of related anesthetics,postoperative pain,postoperative exercise,incidence of adverse reactions,postoperative discharge days and patients' satisfaction with analgesia.Results:(1)30 minutes after iliofemoral space block,HR of group C was lower than that before block,map of group B and group C was lower than that before block,the difference was statistically significant(P > 0.05).There was no significant difference in HR,map 30 minutes after iliofemoral space block between group A and the time of entering the operating room(P > 0.05).There was no significant difference in HR and map between the three groups(P > 0.05).(2)the dosage of sufentanil and PCA in group A were higher than those in group B and group C(P < 0.05).There was no significant difference in sufentanil dosage and PCA dosage in group B and C(P > 0.05).(3)rest pain:(1)the rest pain scores of the three groups at 6h after operation were lower than those of the patients entering the operating room,the difference was statistically significant(P < 0.05),but there was no statistical significance between the three groups(P > 0.05).There was no significant difference in the rest pain score of 12 hours and 24 hours after operation among the three groups(P > 0.05).(2)motor pain: the scores of motor pain in the three groups at 6h after operation were lower than those in the operating room,the difference was statistically significant(P < 0.05),and the difference was statistically significant(P < 0.05)between group B and group C.The difference was statistically significant(P < 0.05).There was no significant difference between the two groups(P > 0.05).(4)the elevation of straight leg in group A was higher than that in group B and group C at 12 h and 24 h after operation,and the muscle strength of quadriceps femoris was higher than that in group A(P < 0.05).There was no significant difference in straight leg elevation and quadriceps muscle strength between group B and group C(P > 0.05).(5)the adverse reactions of nausea and vomiting in group A were less than those in group B,and those in group B were less than those in group C.The incidence of adverse reactions in group C was significantly higher than that in group A(P < 0.05).There was no significant difference in adverse reactions between group A and group B(P > 0.05).(6)the comfort level of analgesia in group B and group C was higher than that in group A(P < 0.05).The comfortable of analgesia in group B was higher than that in group C(P < 0.05).(7)The postoperative rehabilitation compliance evaluation of group B and Group C was higher than that of group A,with statistically significant difference(P < 0.05).Postoperative rehabilitation compliance evaluation in group C was slightly higher than that in group B,but the difference was not statistically significant(P > 0.05).Conclusion: 1.The effect of ropivacaine in the 0.375% group on ultrasonic iliac fascia space block is better than that in the 0.25% group and equal to that in the 0.5% group,with fewer adverse reactions and higher anesthesia comfort of the patients,which is more conducive to early postoperative recovery.2.The concentration of ropivacaine can be selected according to the patient's condition and the requirements of anesthesia and analgesia. |
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