Effect of Ultrasound-Guided Dexamethasone Compound Ropivacaine Iliofascia Space Block on Pain Caused by Lumbar Anesthesia in Patients With Total Hip Replacement

Objective To observe the effect of dexamethasone complex ropivacaine on reducing lateral side pain in patients undergoing total hip arthroplasty. Methods 120 patients aged 45 to 75 years who were recommended to undergo unilateral total hip replacement treatment were selected and randomly divided into 4 groups of 30 each and receive treatment as following: 5 μg sufentanyl injection was injected before lumbar anesthesia in Group A, ropivacaine and saline in group B; dexmedetomidine combined with ropivacaine in group C; dexamethasone plus ropivacaine in group D. Electrocardiogram and pulse oxygen saturation were routinely monitored (SpO 2 ), invasive mean arterial pressure (MAP), heart rate (HR), and pain visual analogue score (VAS) at 0, 5, 10 and 15 minutes after administration ( T 0 , T 1 , T 2 and T 3 ) were assessed for the patients in the operating room. The operation duration, anesthesia operation duration, intraoperative bleeding volume, patient anesthesia satisfaction, adverse reactions such as hypotension, bradycardia, chills and nausea and vomiting, and the number of postoperative intravenous analgesia pump dosage presses were recorded. Results Comparison of the hemodynamic changes between the groups: at T 2 , the fluctuations in HR and arterial blood pressure in group D (10 minutes after dose) were smaller than those of the other 3 groups, with statistically significant differences ( P < 0.05); at T 3 , the arterial blood pressure and HR fluctuations in groups B, C and D were smaller than those in group A, with A statistically significant difference ( P < 0.05). VAS scores at T 2 and T 3 Time points were statistically significant reduced than T 0 in group B, C and D ( P < 0.05); in group C and D, VAS score at T 1 were significantly lower than T 0 , which was not observed in other groups; none of the 4 groups had adverse event such as hypotension, bradycardia, nausea and vomiting, and local anesthetic poisoning ( P > 0.05). In groups C and D, the number of postoperative analgesic pump dosage presses was significantly less than that in groups A and B, with a significant difference ( P < 0.05). Conclusion Ultrasound-guided dexamethasone compound ropivacaine fascia iliaca space block can significantly reduce the pain caused by lateral lumbar anesthesia in total hip replacement surgery, and facilitate the hemodynamic stability of patient, better patient comfort and higher satisfaction with anesthesia. Combined dexmedetomidine and dexamethasone had better postoperative analgesia and less opioid use in the analgesic pump. Compared with the dexamethasone compound ropivacaine group, the nerve block was faster and patients were more satisfied with anesthesia, which was conducive to postoperative rehabilitation and worthy of clinical promotion and application.