Effects of ultrasound-guided fascia iliaca compartment block combined with patient-controlled intravenous analgesia on postoperative analgesia and the incidence of complications in elderly patients undergoing hip arthroplasty
TANG Dan
ZHAO Li
YUAN Chunmei
PENG Zhiyong
LUO Chaojun
LUO Xiaoling
LUO Jie
Abstract：Objective To investigate the effects of ultrasound-guided fascia iliaca compartment block(FICB)combined with patient-controlled intravenous analgesia(PCIA)on postoperative analgesia and the incidence of complications in elderly patients undergoing hip arthroplasty.Methods A total of 117 elderly patients,aged≥60 years,of American Society of Anesthesiologists(ASA)physical statusⅠ-Ⅲ,who underwent hip arthroplasty in Yantian District People's Hospital of Shenzhen from November 2021 to November 2024 were enrolled.The patients were assigned to group A(n=39,FICB was performed 30 min before surgery),group B(n=39,PCIA was administered postoperatively),and group C(n=39,FICB 30 min before surgery+PCIA postoperatively),according to the random drawing method.All patients were followed up for 30 d after surgery.The three groups were compared in terms of recovery status[quality of recovery-40(QoR-40)scores],inflammatory cytokine levels[interleukin-6/interleukin-10(IL-6/IL-10)and tumor necrosis factor-alpha(TNF-α)],incidence of delirium and other complications,and quality of life[short form-36 health survey(SF-36)scores]and pain intensity[numeric rating scale(NRS)].Results Compared with the pre-anesthesia baseline,QoR-40 scores at 24 h and 72 h after surgery in all three groups decreased initially and then increased.At both 24 h and 72 h postoperatively,QoR-40 scores were highest in group C,followed by group A,and lowest in group B,with statistically significant differences among the three groups(P＜0.05).Compared with pre-anesthesia,IL-6 and TNF-α levels at 24 h and 72 h postoperatively were lower in all three groups,with the lowest levels in group C,while IL-10 levels were higher,with the highest levels in group C(all P＜0.05).However,there were no statistically significant differences in IL-6,IL-10,or TNF-α levels between group A and group B(P＞0.05).Within 7 days after surgery,there were no significant differences among the three groups in the incidence of delirium or in the incidence of complications(nausea,vomiting,respiratory depression,somnolence)(P＞0.05).Compared with preoperative values in each group,SF-36 scores at 30 d postoperatively were higher in all three groups;the intergroup comparisons showed that group C＞group A＞group B,with statistically significant differences(P＜0.05).Conclusion FICB combined with PCIA can promote postoperative recovery in elderly patients undergoing hip arthroplasty,reduce inflammatory cytokine levels and the risk of adverse events,as well as improve quality of life.
Keywords：hip arthroplastyultrasound-guided fascia iliaca compartment blockpatient-controlled intravenous analgesiaanalgesic effectinflammatory cytokinespostoperative delirium
Publication Date：2026-02-15
Online Publishing Date：2026-03-19(First online date of this platform, not the publication date of the document)
Pages：6( 37-42 )