Application of Ultrasound-Guided Peri-Articular Nerve Block Around the Hip Joint in Elderly Patients with Hip Fractures

doi:10.3969/j.issn.1004-5775.2025.02.012

Abstract：Objective: To compare and analyze the application effects of ultrasound-guided peri-articular nerve block around the hip joint and iliofascial space block in elderly patients with hip fractures during surgery, to provide reference for clinical anesthetic management of hip fracture surgery in the elderly. Methods: A total of 116 elderly patients with hip fractures admitted to Luoyang Zhenggu Hospital from April to November 2022 were selected as the study subjects and randomly divided into a control group (58 cases) and a study group (58 cases). The control group received ultrasound-guided iliofascial space block before general anesthesia, while the study group received ultrasound-guided peri-articular nerve block around the hip joint before general anesthesia. All patients were observed up to 36 hours postoperatively. The time of puncture operation, onset time, ultrasound imaging time, and surgical time were compared between the two groups. Additionally, the visual analog scale (VAS) scores at rest and during movement at 4, 8, 16, 24, and 36 hours postoperatively were compared. The passive hip flexion angle at 8, 10, and 12 hours postoperatively and the degree of lower limb motor blockade at 8, 10, and 24 hours postoperatively were also compared. Results: The puncture operation time, onset time, ultrasound imaging time, and surgical time in the study group were shorter than those in the control group, with statistically significant differences (t=7.588, 7.558, 22.583, 2.195, P<0.05). Compared with 4 hours postoperatively, the VAS scores at rest and during movement at 8, 16, and 24 hours postoperatively showed an upward then downward trend in both groups, with the study group having higher scores than the control group, with statistically significant differences (t=3.200, 3.215, 3.958, P<0.05; t=3.779, 3.366, 5.367, P<0.05). At 8, 10, and 12 hours postoperatively, the passive hip flexion angles in both groups showed an increasing trend, with the study group showing greater angles than the control group, with statistically significant differences (t=16.788, 17.635, 18.566, P<0.05). At 8, 10, and 24 hours postoperatively, the degree of lower limb motor blockade in both groups showed a decreasing trend, with the study group showing less blockade than the control group, with statistically significant differences (t=9.168, 12.239, 13.586, P<0.05). Conclusion: Both ultrasound-guided peri-articular nerve block around the hip joint and iliofascial space block provide good analgesic effects for elderly patients with hip fractures. Among them, the peri-articular nerve block around the hip joint can shorten the operation time and ultrasound imaging time, increase the passive hip flexion angle, and result in a lower degree of lower limb motor blockade, which is beneficial for postoperative recovery of patients.