The Effect Ofsinglefascia Iliaca Compartment Block Combined With PCIA On Postoperative Analgesia In Patients After THA

Objective This experiment is based on the concept of multimodal analgesia,and the efficacy and safety of analgesia can be evaluated by the effect and stress responseafter THA combined with fascia iliaca compartment block and patient-controlled intravenous analgesia(PCIA).Methods This trial is a randomized clinical study,blind method,negative control.patients,in First Hospital Affiliated to the University of South China,divided into two groups,underwent total hip arthroplastyand ASA classified I to III,All the patients were subjected to unilateral total hip replacement surgery under combined spinal-epidural anesthesia,postoperative the experimental group were given fascia iliaca compartment block with PCIA multimodal analgesia,while the control group received only PCIA.Records of two patients of 6h,12 h,24h after analgesia static VAS score,Ramsay sedation score and BCS score,12 h,24h dynamic VAS score,adverse reaction and the number of patients within 24 h after pressing PCIA(nausea and vomiting,respiratory depression and lethargy)occurred.Venous blood was collected at three time points,which were before anesthesia,Instantly and 24 hours after operation,and the method of ELISA was used to detected the levels of epinephrine,norepinephrine and dopamine in serum.Result 1.Compared with the control group,the static state and the state of motion for all time points after operation in the experimental group 24 h observed within the VAS score were significantly decreased(P<0.05);2.Compared with the control group,there was no significant difference in 12 h and 24 h Ramsay sedation score(P>0.05),while the 12 h and 24 h BCS comfort score,degree of comfort scorebetween 12 and 24 h increased significantly.(p< 0.05);3.Compared with the control group,the total press of PCIAdecreased significantly within 24 hours in the experimental group(p< 0.05);4.Compared with the control group,the incidence of nausea and vomiting in the experimental group was significantly decreased(p< 0.05);5.Compared with the patients before anesthesia,the concentration of the immediate adrenaline,norepinephrine and dopamine in the two groups increased significantly(p< 0.05).Compared with the patients who were at the end of operation,the concentrations of epinephrine in two groups of patients after 24 h,norepinephrine and dopamine were significantly lower(P<0.05).There was no significant difference in serum adrenaline,norepinephrine and dopamine between two groups(p> 0.05)in those two time points.In the postoperative time point of 24 h,compared with the control group,the concentrations of the serum adrenaline, norepinephrine and dopaminein the experimental group decreased more significantly(p< 0.05).Conclusion 1 fascia iliaca compartment block combined with PCIA multimodal postoperative analgesia has better than PCIA alone after THA;2 fascia iliaca compartment block combined with PCIA multimodal postoperative analgesia has better than PCIA in inhibiting stress reaction effect.after THA...