Efficacy of ropivacaine combined with dexmedetomidine and dexamethasone for iliac fascia space block in postoperative pain management for elderly patients with hip fractures
WANG Ping
SHI Rongqiang
Abstract：Objective To evaluate the efficacy of ropivacaine combined with dexmedetomidine and dexamethasone for iliac fascia space block in postoperative pain management for elderly patients with hip fractures,and to provide a theoretical basis for optimising perioperative pain management protocols for elderly patients with hip fractures.Methods Ninety el-derly patients with hip fractures undergoing elective surgery were selected and randomly divided into the control group,ropi-vacaine group,and combination group,with 30 patients in each group.Patients in the control group received plain spinal an-aesthesia,patients in the ropivacaine group received ropivacaine iliac fascia space block combined with spinal anaesthesia,and patients in the combined group received ropivacaine+dexmedetomidine+dexamethasone iliac fascia space block com-bined with spinal anaesthesia.All groups received intravenous patient-controlled analgesia postoperatively.The following parameters were compared between groups:preoperative,pre-positioning,and postoperative 6-,12-,24-,and 48-hour visu-al analogue scale(VAS)pain scores;postoperative analgesic pump presses and rescue analgesia doses within 48 h;preoper-ative and postoperative 1-day serum brain-derived neurotrophic factor(BDNF)and its receptor TrkB levels;and postopera-tive adverse event incidence rates.Results There were no statistically significant differences in preoperative VAS scores among the groups(P>0.05).Before positioning and at 6 h postoperatively,the VAS scores in the ropivacaine group and com-bination group were lower than those in the control group.At 12,24,and 48 h postoperatively,the VAS scores in the combi-nation group were lower than those in the control group and ropivacaine group(all P<0.05).The numbers of analgesic pump presses and analgesic rescues postoperatively were larger in the control group than in the ropivacaine group and the combina-tion group(all P<0.05).There were no statistically significant differences in preoperative serum BDNF or TrkB levels among groups(all P>0.05);postoperative serum BDNF and TrkB levels increased at 1 day postoperatively,and they were as follows:the combination group>ropivacaine group>control group(all P<0.05).The incidence of adverse reactions was sig-nificantly higher in the control group than in the ropivacaine group,and higher in the ropivacaine group than in the combina-tion group(all P<0.05).Conclusion The combination of ropivacaine,dexmedetomidine,and dexamethasone for iliac fascia space block effectively alleviates postoperative pain in elderly patients with hip fractures and prolongs the analgesic du-ration.The mechanism may be related to the regulation of the BDNF/TrkB signaling pathway.
Keywords：ropivacainedexmedetomidinedexamethasoneiliac fascia space blockhip fracturethe aged
Publication Date：2025-08-25
Online Publishing Date：2025-09-10(First online date of this platform, not the publication date of the document)
Pages：4( 72-75 )