Effects of modified fascia iliaca compartment block combined with general anesthesia on intraoperative hemodynamics and recovery quality in children with femoral fracture at medium and high altitudes

Liu Ying; Zhang Tao; Sun Xiaohong; Yang Xiaomei

doi:10.3760/j.issn.1673-4777.2026.05.018

Abstract：Objective To investigate the effects of modified fascia iliaca compartment block combined with general anesthesia on intraoperative hemodynamics and recovery quality in children with femoral fracture at medium and high altitudes.Methods A total of 80 children undergoing elective femoral fracture surgery admitted to Qinghai Province Women & Children's Hospital from May 2023 to May 2025 were selected and divided into control group and observation group by random number table method,with 40 cases in each group.The control group received tracheal intubation general anesthesia,and the observation group received combined fascia iliaca compartment block on the basis of the control group.The intraoperative dosage of anesthetics,awakening time,extubation time and length of stay in post-anesthesia care unit(PACU)were recorded in both groups.Hemody-namic indicators(systolic blood pressure,diastolic blood pressure and heart rate)at different time points[before anesthesia(T0),5 min after intubation(T1),skin incision(T2),30 min after operation start(T3),end of operation(T4)]were compared between the two groups.The behavioral pain scale for children(FLACC)scores at different time points(transfer out of PACU,2 h,4 h and 12 h after operation)were compared between the two groups.The incidence of adverse reactions was statistically analyzed.Results With time extension,the changing trends of systolic blood pressure,diastolic blood pressure and heart rate were different between the two groups,and the observation group showed a smaller changing trend(all P＜0.05).Compared with the control group,the dosages of propofol and remifentanil in the observation group were lower[(287±29)mg vs(311±32)mg,(10.4±2.4)μgvs(12.8±2.5)μg](allP＜0.05).Compared with the control group,the FLACC scores in the observation group were lower at transfer out of PACU,2 h,4 h and 12 h after operation(all P＜0.05);with time extension,the FLACC scores in both groups first increased and then decreased,and the observation group showed a smaller changing trend(P＜0.05).Compared with the control group,the awakening time,extubation time and PACU stay time in the observation group were shorter[(53±5)min vs(57±5)min,(9±3)min vs(12±3)min,(31±5)min vs(35±5)min](all P＜0.05).There were no significant differences in the incidence of adverse reactions between the two groups(all P＞0.05).Conclusions Modified fascia iliaca compartment block combined with general anesthesia has significant effects on children with femoral fracture at medium and high altitudes,which is conducive to maintaining hemodynamic stability,reducing the dosage of anesthetics,promoting postoperative recovery,shortening awakening time,with high safety.