Objective To explore the effect of intravenous analgesia and continuous fascia iliac compartment block (FICB) on postoperative cognitive function and stress level in elderly patients undergoing hip surgery.
Methods Eighty patients with hip surgery, 31 males and 49 females, aged 65-89 years, ASA physical status Ⅰ-Ⅲ, were randomly divided into two groups: intravenous analgesia control group (group C) and 0.2% ropivacaine continuous pulse FICB group (group F), 40 patients in each group. The VAS scores at rest and exercise, HR, MAP and SpO2 were recorded 6, 12, 24, and 48 hours after operation. Salvage analgesia, nausea, vomiting and dizziness were recorded after operation. MMSE was used to assess cognitive function 1 day before the surgery and 1 day, 3, 5, and 7 days after operation. The ELISA was used to detect the level of serum S100B protein and melatonin 1 day before the surgery and 1 day, 3, 5, and 7 days after operation.
Results The VAS exercise score 6, 12, 24 and 48 hours after operation in group F was respectively lower than that in group C (P < 0.05). There was no difference in VAS score at rest, HR, MAP and SpO2 between the two groups after operation. Tramadol salvage analgesia rate, nausea, vomiting, dizziness and other adverse reactions in group F within 48 hours after operation were lower than those in group C (P < 0.05). Compared with 1 day before the surgery, MMSE and the level of melatonin were decreased and the level of S100B was increased between the two groups 1 day and 3 days after operation (P < 0.05). Compared with group C, MMSE and the level of melatonin in group F were increased, level of S100B was decreased (P < 0.05).
Conclusion Continuous FICB in elderly patients with hip fracture after surgery can provide more complete analgesia, reduce the use of intravenous analgesics and stress, reduce the impact of early postoperative cognitive function. |
