Effect of ropivacaine preemptive analgesia on pain control and stress hormone levels in young and middle-aged patients with femoral neck fractures
Tuo Jinli
Yang Yan
Abstract：Objective To observe the analgesic efficacy of ropivacaine preemptive analgesia in young and middle-aged patients with femoral neck fracture and its influence on the level of serum trauma stress factor.Methods A total of 104 pa-tients with femoral neck fractures who were treated in Jianli People's Hospital from March 2022 to January 2023 were selected as the research subjects and divided into a control group and a study group according to the method of random number tables,with 52 in each group.60min before the operation,the study group performed ultrasound-guided iliofascial block with 0.25% ropiva-caine compound solution,the dose of 40mL;the control group did not undergo iliac fascia block.The analgesic effect of patients at 2 hours,4 hours,6 hours,12 hours,24 hours,48 hours,and 3 days after surgery was determined and the serum inflammatory pain mediators(interleukin-6(IL-6),tumor necrosis factor(TNF-α),C-reactive protein(CRP),prostaglandin E2(PGE2),β Endorphin(β-EP)),stress hormones(cortisol(Cor)and adrenocorticotropic hormone(ACTH))in patients before and 24 hours after surgery were observed.Results There was no statistically significant difference in the duration of surgery and intraoperative bleeding be-tween the two groups(P>0.05).The amount of fentanyl used for postoperative analgesia in the study group was less than that in the con-trol group(P<0.05).The visual analog scores of patients in the study group at 2,4,6,12,24,48 hours and 3 days after surgery((3.49±0.66),(3.07±0.54),(2.80±0.51),(2.35±0.43),(1.83±0.44),(1.38±0.31),(0.78±0.21)points)were lower than those of the control((4.05±0.72),(3.84±0.59),(3.63±0.53),(3.09±0.46),(2.87±0.49),(2.13±0.37),(1.55±0.30)points),with statistically significant differences(all P<0.05).In 24 hours after operation,the levels of serum IL-6,TNF-α,CRP,PGE2,β-EP,Cor and ACTH were lower in the study group((42.73±6.69)ng·L-1,(2.92±0.54)ng·mL-1,(9.52±2.08)mg·L-1,(18.74±2.35)pg·mL-1,(133.48±14.55)pg·mL-1,(342.16±58.72)ng·mL-1,(67.77±10.15)ng·L-1)than those in the control((55.89±7.12)ng·L-1,(3.75±0.58)ng·mL-1,(14.63±2.36)mg·L-1,(25.26±2.52)pg·mL-1,(150.79±15.27)pg·mL-1,(397.80±60.43)ng·mL-1,(83.36±11.19)ng·L-1)(P<0.05).The incidence of nausea,vomiting and dizziness in the study group(1.92%,11.54% )was significantly lower than that in the control group(17.31%,28.85% )(χ2=7.081,4.833,P=0.008,0.028).Conclusion Ropivacaine pre-emptive analgesia can significantly improve the perioperative pain condition in young and middle-aged patients with femoral neck fractures.
Keywords：RopivacainePreemptive analgesiaFemoral neck fractureInflammatory pain mediatorStress hormone
Publication Date：2025-07-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 664-667 )