Application of ultrasound-guided nerve block combined with patient-controlled intravenous analgesia after orthopedic surgery in elderly patients analgesia for enhanced recovery after surgery

Abstract

Objective To observe the effect of ultrasound-guided nerve block combined with patient-controlled intravenous analgesia(PCIA) as a postoperative analgesic method for elderly patients with lower limb orthopedic surgery. Methods Seventy-two elderly patients undergoing lower limb orthopedic surgery are randomly divided into three groups, each consisting of 24cases: patient-controlled intravenous analgesia(PCIA) group (group Ⅰ), ultrasound-guided single injection of nerve block analgesia + PCIA group (group Ⅱ), ultrasound-guided continuous injection of nerve block analgesia + PCIA group (group Ⅲ). The VAS scores of pain and the doses of sufentanil are compared at the 6th, 12th, 24th, 36th, and 48th hours after surgery, and the postoperative adverse reactions and overall satisfaction were observed. Results At the 6th, 12th, 24th, and 36th hours after operation, the differences in the doses of sufentanil and VAS scores between the groups are statistically significant (P<0.01), with the highest in group Ⅰ and the lowest in group Ⅱ. Differences in the incidence of adverse reactions between the groups are statistically significant (χ2=9.333, P<0.01), with the highest in group Ⅰ (45.83%) and the lowest in group Ⅲ (8.33%). Differences in the overall satisfaction between the groups are statistically significant (χ2=6.799, P<0.05), with the highest in group Ⅱ (66.67%) and the lowest in group Ⅰ (29.16%). Conclusion Being both effective and safe, ultrasound-guided nerve block combined with PCIA is an ideal postoperative analgesic method for elderly patients with lower limb orthopedic surgery. Key words: Ultrasound; Nerve block; Analgesia; Enhanced recovery after surgery