Effects Of Ultrasound-guided Pericapsular Nerve Group Block On Postoperative Sleep Quality In Elderly Patients With Hip Fracture

Objective Hip fracture is the most common fracture type in the elderly.With the increase of age,the elderly’s physical function gradually decreases,which is prone to osteoporosis,which is the pathological basis of hip fracture.Intertrochanteric fracture and femoral neck fracture accounted for more than 90% of hip fractures.It’s also a common type of fracture in older people.Pain is the first and common symptom of the vast majority of patients after orthopedic surgery.Pain will lead to many adverse reactions and affect the postoperative recovery of patients.Severe pain after hip fracture will also lead to short-term sleep disorders in the early postoperative period.Sleep quality and postoperative pain are important determinant factors for the recovery of postoperative body function.Therefore,the purpose of our study was to observe the effect of ultrasound-guided hip pericapsular nerve Group block（PENG）anesthesia on sleep quality in elderly patients after hip fracture surgery.Methods A total of 90 inpatients,27 males and 63 females,aged 60-85 years,with ASA Ⅰ～Ⅱ grade,who planned to undergo elective hip fracture surgery from May 2020 to February 2021,were randomly divided into 3 groups.Fascia iliaca Block（FICB）Group A: blank control group（n=30）Group B: Hip joint pericapsular nerve block（n=30）Group C: Fascia Iliaca Block（FICB）group（n=30）Patients in group A underwent surgery without treatment after general anesthesia.Patients in group B underwent ultrasound-guided pericapsular nerve block anesthesia of the hip joint after general anesthesia,and then surgery began.Patients in group C underwent ultrasound-guided iliac fascial space block anesthesia following general anesthesia,followed by surgery.All patients were sent to resuscitation room after operation.Postoperative T0,T1,T2,T3,T4,T5 pain score using Visual analogue scale（VAS）.Comparison of the time to get out of bed for the first time and the amount of opioids in the three groups during operation.According to the Pittsburgh Sleep Quality Index Scale（PSQI）and Athens Insomnia Self-rating Scale（Athens Insomnia Self-rating Scale）,AIS)to evaluate the sleep status of T0,T1,T2,T3,T4 and T5,and to evaluate the postoperative recovery of T1,T2,T3,T4 and T5 by referring to Rehabilitation Quality Scale-15（QOR-15）.The incidence of postoperative adverse reactions in each group was recorded.Results Compared with group A,intraoperative use of opioids in group B and C was significantly reduced,and the difference was statistically significant（P<0.05）.The resting VAS scores of T1 and T2 in group B and C were significantly smaller than those in group A,and the differences were statistically significant（P<0.05）.The time of first ambulation in group B was significantly earlier than that in group A and C,and the difference was statistically significant（P<0.05）.Postoperative sleep quality of group B and C was significantly better than that of group A,and the difference was statistically significant（P<0.05）.Conclusion Ultrasound-guided hip pericapsular nerve block has better analgesic effect and more accurate range than iliac fascial space block,which can greatly improve the postoperative sleep quality of patients with hip fracture.Patients can get out of bed early and promote postoperative recovery.