| Objective:To compare the analgesic effects of fascia iliaca compartment block with "hillside-pattern" approach and "tie-pattern" approach on perioperative pain management in patients undergoing hip surgery.Methods:Forty patients who undergoing hip surgery in our hospital from March 2022 to June 2022 were selected as the study subjects.Age 18～80 years old,gender unlimited,ASA Ⅰ--Ⅲ grade,According to the random number table method,they were divided into the "hillside-pattern" group and the "tie-pattern" group with 20 patients in each group.Before intraspinal anesthesia,the two groups were respectively subjected to fascia iliaca compartment block through the two approaches under the guidance of ultrasound,and the concentration of both groups was0.33% ropivacaine hydrochloride 30 ml.The changes of mean arterial blood pressure and heart rate of the two groups were recorded before,during and 1h after operation.Operation time of block,block onset time and block effect of femoral nerve and femoral lateral cutaneous nerve;VAS pain scores before block(T1),at the beginning of surgery(T2),and at1h(T3),12h(T4)and 24h(T5)after surgery;Analgesic satisfaction score;Postoperative nausea and vomiting,hypotension,bradycardia and other adverse reactions.Results:1.The onset time of femoral nerve and lateral femoral cutaneous nerve block in group S was significantly shorter than that in group L(14.0(14.0,15.0)vs16.0(15.0,18.8);14.3(14.0,15.0)vs16.5(15.0,18.0);P<0.05).2.At T4,the postoperative resting VAS pain score in group S was lower than that in group L(2.0(1.0,4.0)vs5.0(4.5,8.0);P<0.05),and there was no significant difference in resting VAS scores between the two groups at the other moments.3.Analgesic satisfaction in group S was better than that in group L(7.0(6.0,8.0)vs6.0(6.0,7.0);P<0.05).Mean artery pressure and heart rate at all times of the two groups;There was no significant difference in the operation time and the blocking effect between femoral nerve and lateral femoral cutaneous nerve.There was no significant difference in the incidence of postoperative adverse reactions between the two groups.Conclusion:The use of ultrasound-guided fascia iliaca compartment block has good analgesic effect in perioperative analgesic management in patients undergoing hip surgery.Moreover,the "hillside-pattern" approach was more effective than the "tie-pattern" approach in blocking the femoral nerve and lateral femoral cutaneous nerve,and the analgesic effect was better at 12 h after surgery,and the analgesic satisfaction score was higher. |
