Dexamethasone combined with ropivacaine for preoperative analgesia in elderly patients with hip fracture
HAN Yang，CAO Hong-wei，ZHANG Yi
Department of Anesthesiology, Chun' an County Hospital of Traditional Chinese Medicine, Hangzhou (311700), China
Abstract:
Objective To investigate the application of dexamethasone combined with ropivacaine in ultrasound-guided pericapsular nerve block of hip joint for preoperative analgesia in elderly patients with hip fracture. Methods From January 2017 to March 2022, 103 elderly patients with hip fracture who visited our hospital were gathered and grouped into control group (n=51) and therapy group (n=52) according to random number table method. Before spinal anesthesia, the patients in the group underwent ultrasound-guided pericapsular nerve block of hip joint, the control group was injected with 0.5% ropivacaine, and the therapy group was injected with 0.5% ropivacaine + 8 mg dexamethasone. The NRS pain scores of patients in resting state and exercise state were observed and compared at 6 h, 12 h, 24 h and 48 h after operation, respectively, the postoperative conditions (including hospitalization time, time to get out of bed, the number of analgesic drugs used, and the time of first pressing the analgesic pump) of patients of the two groups were compared, the postoperative complications (arrhythmia, puncture hematoma, nausea and vomiting, nerve injury, etc.) were compared between the two groups. Results The NRS scores of the therapy group at 6 h, 12 h, 24 h and 48 h were lower than those of the control group at rest (P<0.05). The NRS scores at 6 h, 12 h, 24 h and 48 h in the therapy group were lower than those in the control group at the exercise state (P<0.05). After operation, the length of hospital stay, time to get out of bed, and the frequency of analgesic use in the therapy group were lower than those in the control group (P<0.05), and the time of first pressing an analgesic pump was higher than that in the control group (P<0.05). The incidence of postoperative complications such as arrhythmia, puncture hematoma, nausea and vomiting, and nerve injury in the therapy group was 5.77% (3/52), which was lower than that in the control group, 21.57% (11/51), the difference was statistically signi.cant(P<0.05). Conclusion Dexamethasone combined with ropivacaine for ultrasound-guided peripheral nerve block of the hip joint has a good preoperative analgesic effect in elderly patients with hip fracture, which can effectively reduce the pain and shorten the hospitalization time of the patients, reduce the incidence of postoperative complications, worthy of clinical application.
