Comparison of different local anesthetics for suprainguinal fascia iliaca compartment block in analgesia for elderly patients undergoing intertrochanteric fracture surgery
HUANG Cheng-xiang
ZOU Xia-yu
WEI Yan
HUANG Yuan-yi
DU Jie-qiang
LU Li-ji
CHEN Zi-wen
HU Xiao-ying
LUO Rui-min
ZHONG Shuo-tao
LIANG Wen-ying
YOU Yu-yuan
Abstract：Objective To investigate the analgesic effect of liposomal bupivacaine(LB)via suprainguinal fascia iliaca compartment block(S-FICB)in elderly patients undergoing intertrochanteric fracture surgery,and to compare it with conventional bupivacaine hydrochloride.Methods A randomized,double-blind controlled study enrolled 36 pa-tients aged 60-75 years with intertrochanteric fracture.Patients were randomly assigned to the liposomal bupivacaine group(LB group)or the bupivacaine hydrochloride group(BH group).Both groups received ultrasound-guided S-FICB.The LB group was administered 40 mL of 0.332 5％liposomal bupivacaine(133 mg),while the BH group re-ceived 40 mL of 0.1％bupivacaine hydrochloride.The primary outcomes were Numerical Rating Scale(NRS)pain scores at rest and during movement at 24 h postoperatively.Secondary outcomes included NRS scores at rest and during move-ment at 12,48,and 72 h postoperatively,opioid(sufentanil)consumption,QOR-15 satisfaction score,incidence of ad-verse events,and length of hospital stay.Results At 24 h postoperatively,both resting and movement NRS scores were significantly lower in the LB group compared to the BH group(resting NRS:LB=2.0 vs.BH=4.0,P＜0.001;move-ment NRS:LB=3.0 vs.BH=6.0,P＜0.001).At 12,48,and 72 h postoperatively,NRS scores at rest and during movement were consistently lower in the LB group than in the BH group(P＜0.001).Opioid consumption was signifi-cantly reduced in the LB group at all time points(P＜0.000 1);the cumulative sufentanil dose at 72 h was(40.22±3.75)μg in the LB group versus(86.56±6.45)μg in the BH group,representing a 53.5％reduction(P＜0.001).The incidence of nausea and vomiting was significantly higher in the BH group compared to the LB group(61.1％vs.16.7％,P＜0.05).QOR-15 scores were significantly higher in the LB group(134.78 vs.111.67;difference 23.11 points,P＜0.000 1).There was no significant difference in hospital stay between groups(P=0.78).Conclusion Li-posomal bupivacaine administered via S-FICB provides continuous analgesia for up to 72 h in elderly patients undergoing intertrochanteric fracture surgery.It significantly reduces opioid consumption,lowers the incidence of adverse events,and improves patient satisfaction and recovery quality.
Keywords：liposomal bupivacainesuprainguinal fascia iliaca compartment blockelderlyintertrochanteric fracturepostoperative analgesia
Publication Date：2025-10-15
Online Publishing Date：2025-11-28(First online date of this platform, not the publication date of the document)
Pages：6( 1478-1483 )