Ultrasound-guided iliac fascia block in hip arthroplasty in elderly patients

GAO Gui; MA Qi-gang; LIU Bo; LIANG Qi-lou; ZHANG Jia-hong

doi:10.3969/j.issn.2095-252X.2025.07.012

Abstract：Objective To observe the application effect of ultrasound-guided iliac fascia block in hip arthroplasty(HA)in elderly patients.Methods 110 cases of elderly patients who underwent hip arthroplasty under lumbar-rigid combined anesthesia on an elective basis in our hospital from April 2021 to April 2024 were selected and divided into the control group(n=55)and the observation group(n=55)by using the method of randomized numerical table.In the control group,lumbar-rigid combined anesthesia was adopted;and in the observation group,ultrasound-guided iliac fascia block was implemented before lumbar-rigid combined anesthesia.Heart rate(HR)and mean artery pressure(MAP)were compared between the two groups.Postoperative analgesic medication,stress response indexes,and postoperative complications were recorded.Visual analogue scale(VAS)was used to compare the degree of pain;Pittsburgh Sleep Quality Index(PSQI)and Montreal Cognitive Assessment Scale(MoCA)were used to compare the quality of sleep and cognitive function.Results MAP and HR at T1,T2,T3,and T4 were lower in the observation group than in the control group(P<0.05).Postoperative sufentanil dosage of the observation group was less than that of the control group.Patient controlled intravenous analgesia(PCIA)started to press later than that of the control group,and the number of PCIA presses was less than that of the control group(P<0.05).The levels of superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)in the observation group were higher than those in the control group at 1 and 3 days postoperatively,and the levels of advanced oxidation protein products(AOPP)and malonic dialdehyde(MDA)were lower than those in the control group(P<0.05).The VAS scores of the observation group were lower than those of the control group at 12 hours,1 day,2 days and 3 days postoperatively(P<0.05).At 1,2,and 3 days postoperatively,the PSQI score of the observation group was lower than that of the control group,and the MoCA score was higher than that of the control group(P<0.05).The total postoperative complication rate of the observation group was lower than that of the control group(P<0.05).Conclusions Ultrasound-guided iliac fascia block applied to HA in elderly patients can significantly improve perioperative analgesia,reduce the dose of postoperative analgesic drugs,alleviate the body's stress response,reduce postoperative pain,improve short-term postoperative cognitive function,and reduce the complication rate.