Fascia Iliaca Compartment Block For Post Operative Analgesia Of Femoral Intertrochanteric Fracture Of Elderly Patients

objectives:To compare the post-operative analgesia effect of ultrasound guided fascia iliaca compartment block with ropivacaine and patient controlled intravenous analgesia in femoral intertrochanteric fracture of elderly patientsMaterials and Methods:60 patients with femoral intertrochanteric fracture from 2016.01-2017.01 scheduled for surgery were selected and randomly divided into two groups,patients in Group A received fascia iliaca compartment block and 0.5%ropivacaine 20ml were injected by the catheter as initial dose before general anaesthesia,which patients in Group B did not received.Both groups received generel anaesthesia and after surgery,patients in Group A received continuous fascia iliaca compartment block with 0.2%ropivacaine(5ml/h,PCA 5ml,lock time 15min)for 48h,and Patients in Group B received patient controlled intravenous analgesia with fentanyl(lml/h,PCAlml,lock time 15min)for 48h.pain was accessed using VAS at the moment of leaving PACU,2h,6h,12h,24h,48h after surgery and also Ramesay score were recorded,and D1/D2.Results:1.Compare to Group B,VAS scores at-rest of Group A at time of leaving PACU and dynamic VAS scores at 24h after surgery were significant lower(P<0.05)2.Compare to Group B,Ramesay scores of Group A at time of 6h,12h after surgery were significant lower(P<0.05)3.Compare to Group B,dosage of remifentanil of Group A was significant lower(P<0.05).Conclusion:Compare to patient controlled intravenous analgesia with fentanyl,continuous ultrasound guided fascia iliaca compartment block with 0.2%ropivacaine provide effect analgesia for femoral intertrochanteric fracture elderly patients,and block before anaesthesia can reduce dosage of anesthetic.objectives:To study the minimum effective concentration of Ropivacaine in ultrasound guided fascia iliaca compartment block analgesia for femoral intertrochanteric fracture of elderly patientsMaterials and Methods:Patients with femoral intertrochanteric fracture from 2016.01-2017.01 scheduled for surgery were selected and received fascia iliaca compartment block and 0.5%ropivacaine 20ml were injected by the catheter as initial dose and 30min observation before general anaesthesia,after surgery patients received continuous fascia iliaca compartment block with 0.1%ropivacaine(5ml/h,PCA 5ml,lock time 15min)for start and using up-and-down method,the concentration of ropivacaine administred to each patient depend on the response of the previous one,in case of failure,the concentration was increased by 0.025%for the next patient,and on the contrary the concentration was decreased by 0.025%.pain was accessed using VAS and when VAS score at-rest ≤2 and dynamic VAS score ≤3 was considered as successful analgesia.And VAS score of patients and response were abserved and noted,and the minimum effective concentration of ropivacaine was calculated by Dixon-Massey method.Results:Ec50 concentration of ropivacaine was 0.133%(0.116-0.157)by Dixon-Massey methodConclusion:with initial dosage of 0.5%ropivacaine 20ml and 5ml/h as background bolus,PCA 2ml,and locktime 15min,Ec50 concentration of ropivacaine was 0.133%(0.116-0.157)in ultrasound guided fascia iliaca compartment block analgesia for femoral intertrochanteric fracture of elderly patients.