Application of iliac fascia gap blockage in elderly patients with femoral intertrochanteric fractures and its impact on stress indicators / 中国基层医药

ABSTRACT

Objective@#To investigate the anesthetic effect of the iliac fascia gap block in patients with senile femoral intertrochanteric fractures and its effect on stress indicators.@*Methods@#A total of 100 elderly patients with intertrochanteric fractures were selected and randomly divided into control group(n=50) and observation group(n=50) by digital table.The control group was treated with general anesthesia.The observation group was anesthetized with iliac fascia gap block on the basis of the control group.The levels of norepinephrine(NE), epinephrine(E) and cortisol(Cor) were measured by double antibody radioimmunoassay.The effects of anesthesia and stress indicators of the patients were compared.@*Results@#The dosages of propofol and remifentanil in the observation group were (721.21±21.24)mg and (421.25±8.94)μg, respectively, which were less than those in the control group [(946.46±24.35)mg and (545.42±9.13)μg, t=18.832, 19.231, P<0.05]. The time of extubation, the recovery time of anesthesia and agitation score in the observation group were (12.31±0.94)min, (16.43±1.21)min and (1.64±0.39)points, which were significantly lower than those in the control group[(18.43±1.21)min, (24.34±1.43)min, (2.54±0.64)points, t=21.124, 18.432, 19.831, all P<0.05]. Before anesthesia, there were no statistically significant differences in stress indicators and VAS score between the two groups (all P>0.05). The NE, E, Cor levels at 24h after operation had no statistically significant differences between the two groups (all P>0.05). The postoperative 24h VAS scores in the two groups were lower than those after extubation and before anesthesia(t=14.395, 13.882, 19.662, 12.501, all P<0.05). After anesthesia, the levels of NE, E Cor and VAS score in the observation group were (0.61±0.08)μg/L, (0.07±0.02)μg/L, (112.5±20.51)μg/L and (5.64±0.46)points, respectively, which were significantly lower than those in the control group [(0.84±0.12)μg/L, (0.98±0.06)μg/L, (178.42±29.49)μg/L, (6.75±0.49)points, t=10.773, 12.507, 11.295, 15.774, all P<0.05]. The incidence rate of adverse reaction of the observation group was 8.00%, which was lower than 6.00% of the control group, but the difference was not statistically significant(P>0.05).@*Conclusion@#The use of iliac fascia gap blockage in elderly patients with intertrochanteric fractures is effective and can reduce the dose of anesthetic drugs, reduce perioperative stress response, and does not increase the incidence of adverse reactions, it is worthy of application.