Effects of ultrasound-guided pericapsular nerve group block in combination with laryngeal mask airway on anesthesia, postoperative analgesia, and recovery of elderly patients with femoral neck fracture undergoing closed reduction and internal fixation

Introduction: Femoral neck fracture (FNF) frequently occurs in the elderly. Aim:We aimed to assess ultrasound-guided pericapsular nerve group block (PENGB) plus laryngeal mask airway (LMA) general anesthesia from the aspect of anesthetic efficacy in elderly patients suffering from FNF undergoing closed reduction and internal fixation (CRIF), as well as their postoperative analgesia and rapid recovery.Methods: Control group (n=47) and observation group (n=57) were established for FNF patients hospitalized between October 2022 and August 2023 based on different anesthesia modes.Ultrasound-guided fascia iliaca compartment block (FICB) plus LMA general anesthesia was performed for the control group, while ultrasound-guided PENGB plus LMA general anesthesia was conducted for the observation group.Results: In comparison with the observation group, heart rate (HR) and mean arterial pressure rose significantly in the control group at the time of skin incision, 20 min intraoperatively and at the end of operation, and HR also increased at the time of entering the postanesthetic care unit (P<0.05).The observation group, in comparison with the control group, exhibited significantly reduced serum neuropeptide Y and substance P levels at 12 h and 24 h postoperatively, and significantly lowered Visual Analogue Scale scores at various time points following operation (P<0.05).In comparison with the control group, the observation group had significantly shortened postoperative eye-opening time, extubation time and ambulation time (P<0.05). Conclusion:Ultrasound-guided PENGB plus LMA general anesthesia is effective for elderly patients with FNF undergoing CRIF, which can stabilize the intraoperative hemodynamic state.