Key result
Non-opioid ultrasound-guided iliac fascia nerve block under the ERAS concept significantly reduced postoperative complications (8% vs 16%) and shortened hospital stay compared to opioid anesthesia.
Why the study?
The study evaluated the application of an enhanced recovery after surgery concept using ultrasound-guided iliac fascia nerve block in elderly hip fracture surgery patients and its effect on perioperative traumatic stress.
Does non-opioid ultrasound-guided iliac fascia nerve block combined with an ERAS protocol improve hip joint function and reduce complications compared to traditional opioid anesthesia in elderly patients undergoing hip fracture surgery?
RCT (n=100)
No
Does non-opioid ultrasound-guided iliac fascia nerve block combined with an ERAS protocol improve hip joint function and reduce complications compared to traditional opioid anesthesia in elderly patients undergoing hip fracture surgery?
Absolute Event Rate: 8% vs 16%
p-value: p=0.032
Non-opioid ultrasound-guided iliac fascia nerve block combined with an ERAS protocol significantly reduces postoperative complications and hospital stay in elderly patients undergoing hip fracture surgery compared to traditional opioid-based anesthesia.
Associated with fewer complications and shorter stays after hip fracture surgery; leaves open randomized confirmation for non-opioid ERAS protocols.
To discuss the application of enhanced recovery after surgery concept in ultrasound-guided iliac fascia nerve block in elderly hip fracture surgery patients and its effect on traumatic stress in patients during perioperative period. Selected 100 elderly patients undergoing hip fracture surgery in our hospital from January 2021 to September 2021. Divided 50 patients of non-opioid ultrasound-guided iliac fascia nerve block anesthesia into observation group and the other 50 patients of opioid (sufentanil) anesthesia into control group. Compared perioperative heart rate and mean arterial pressure indexes of both groups; compared visual analog scale, sedation-agitation scale and mini-mental state examination scores of patients on the 2 d after surgery; compared cortisol, C-reactive protein and interleukin-6 levels in serum of both groups. Compared Harris hip function score, perioperative complications (pressure sores, lower extremity venous thrombosis, lower limbs swelling, lung infection), length of hospital stay and hospitalization expenses of both groups at 3 mo after surgery. Observation group had lower mean arterial pressure and heart rate during spinal canal intubation than control group, which possessed statistical significance (p<0.05). On the 1 d after surgery, observation group had higher visual analog scale score than control group (p>0.05), but had remarkably lower sedation-agitation scale score than control group (p<0.05), and had remarkably higher mini-mental state examination score than control group (p<0.05). At 3 mo after surgery, observation group had higher affected hip joint Harris score than control group (p<0.05), and postoperative complications rate in observation group (8 %) was remarkably lower than control group (16 %), observation group had remarkably lower hospitalization expenses and length of stay than control group, so the divergence possessed statistical significance (p<0.05). Under the concept of enhanced recovery after surgery, nonopioids under ultrasound-guided iliac fascia nerve block anesthesia can better improve hip joint function, reduce postoperative cognitive dysfunction and reduce postoperative complications in geriatric hip fracture surgery. It can remarkably shorten the length of hospitalization and hospitalization expenses. Compared with traditional opioid spinal anesthesia, it can remarkably accelerate the recovery of patients after surgery.
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Zhang et al. (2022) conducted an RCT in Hip fracture (n=100). Non-opioid ultrasound-guided iliac fascia nerve block anesthesia with ERAS vs. Opioid (sufentanil) anesthesia with traditional care was evaluated on Postoperative complications (p=0.032). Non-opioid ultrasound-guided iliac fascia nerve block under the ERAS concept significantly reduced postoperative complications (8% vs 16%) and shortened hospital stay compared to opioid anesthesia.
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