The Hip Motor Function Benefit of Ultrasound-guided Iliopsoas Plane Block in Elderly Patients Undergoing Hip Replacement Surgery and the Impact of Body Mass Index on Block Effect

XIONG Ying; WANG Pan; WANG Jia; JIANG Tingting

doi:10.3969/j.issn.1002-3429.2025.11.016

Abstract：Objective To explore the benefits of hip motor function in elderly patients undergoing hip replacement surgery under ultrasound-guided iliopsoas muscle plane block,and to analyze the inpact of patients'body mass index(BMI)on the block effect.Methods A total of 103 elderly patients who were admitted from November 2020 to October 2023 for hip replacement surgery were selected as the research subjects.They were first divided into Group I(n=63)and group F(n=40)according to different anesthesia methods.Patients in group I and group F were treated with ultrasound-guided iliopsoas muscle plane block and femoral nerve block technique respectively,and both were injected with 10 mL of ropivacaine for corresponding block.Then intraspinal anesthesia was performed.According to BMI,the patients in group I were evenly divided into the underweight group(group L),the normal weight group(group N),and the overweight group(group H).The sensory block effects of patients in groups L,N and H were compared before nerve block and at 10 min,20 min(T2)and 30 min(T3)after nerve block.The manual muscle strength test(MMT)of the quadriceps femoris immediately after admission to the anesthesia recovery room(PACU)and at 2,4,6,24,and 48 h after operation,the operation time of nerve block,the onset time of nerve block,the time of first off-bed activity,and the remedial analgesia of patients in group I and group F were compared.Meanwhile,the adverse reactions of patients in both groups were recorded.Results Among the three groups of patients with different BMI,the effective rate of sensory block in the lateral femoral cutaneous nerve(LFCN)region at T3 in group H was significantly better than that in group L(P<0.05).The sensory block effect in the femoral nerve(FN)region at T2 in group H was significantly better than that in group L(P<0.05).The sensory block in the ON region at T3 in group H was significantly better than that in group L and group N(P<0.05).Immediately after admission to the PACU and at 2,4,and 6 h after operation,the MMT grade of the quadriceps femoris in group I was higher than that in group F(P<0.05).Compared with group F,the operation time and onset time of nerve block in group I patients were shorter(P<0.01).There was no significant difference in the time of first off-bed activity,the proportion of remedial analgesia and the incidence of adverse reactions between the two groups of patients(P>0.05).Conclusion Ultrasound-guided psoas iliopsoas plane block for analgesia in elderly patients undergoing hip replacement surgery has a good analgesic effect,which can preserve hip motor function,and has good safety.Moreover,for patients with a large BMI,the sensory block effect in the LFCN and ON regions is better within 30 min of nerve block.