Comparison of Anesthetic Effects Between"Hourglass Sign"Iliac Fascia Block and Femoral Nerve Block in Elderly Patients with Femoral Neck Fracture
WANG Pengcheng
WANG Zhen
ZHANG Guoqing
DAI Yanwen
Abstract：Objective To compare the anesthetic effects between"hourglass sign"iliac fascia block and femoral nerve block in elderly patients with femoral neck fracture.Methods The clinical data of 79 elderly patients with femoral neck fracture who underwent surgery in Zhumadian Central Hospital from February 2022 to January 2024 were retrospectively analyzed.According to the anesthesia method,they were divided into a control group(40 cases,ultrasound-guided femoral nerve block)and an observation group(39 cases,ultrasound-guided"hourglass sign"iliac fascia block).The block success rate 15 minutes after anesthesia,intraoperative dosages of propofol and remifentanil,number of rescue analgesia,occurrence of postoperative neurocognitive disorders and complications were observed in the two groups.The degree of pain before and after surgery and the changes in mean arterial pressure(MAP)and heart rate(HR)during the operation were analyzed.Results There were no significant differences in the block success rate and the incidence of neurocognitive disorders at 72 h after surgery between the two groups(P＞0.05).However,the incidences of neurocognitive disorders at 30 min and 24 h after surgery and the complication rate in the observation group were 7.69％,5.13％,and 10.26％,respectively,which were lower than those in the control group(25.00％,20.00％,30.00％)(P＜0.05).There was no statistically significant difference in MAP between the two groups(P＞0.05),but there was a statistically significant difference over time(P＜0.05);the MAP at 15 min after operation start was lower than that before operation and immediately after operation(P＜0.05).There were no statistically significant differences in HR between groups,over time,or in the interaction(P＞0.05).The VAS scores showed statistically significant differences between groups,over time,and in the interaction(P＜0.05);intra-group comparison showed preoperative＞6 h postoperative＞24 h postoperative,with statistically significant differences in pairwise comparisons(P＜0.05);inter-group comparison showed no significant difference before surgery(P＞0.05),but the observation group had lower scores at 6 h and 24 h after surgery(P＜0.05).The intraoperative dosages of propofol and remifentanil and the number of rescue analgesia in the observation group were lower than those in the control group(P＜0.05).Conclusion Compared with femoral nerve block,"hourglass sign"iliac fascia block also achieves a high block success rate.It can reduce the intraoperative dosages of propofol and remifentanil,alleviate postoperative pain,and lower the risks of neurocognitive disorders and complications,with more stable MAP and HR.
Keywords：hourglass signiliac fascia blockfemoral nerve blockelderlyfemoral neck fractureanesthesia
Publication Date：2026-03-13
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：5( 833-837 )