The effect of the fascia iliaca compartment block combined with laryngeal mask general anesthesia on the internal fixation of senile femoral neck fracture

摘要

Objective: To explore the effect of fascia iliaca compartment block (FICB) combined with a laryngeal mask on the internal fixation of senile femoral neck fracture (FNF) and its improvement on cognitive and immune functions. Methods: 72 patients with FNF in our hospital were enrolled in the study. All the patients underwent internal fixation and were randomly divided into a study group (SG) and a control group (CG), with 36 cases in each group. The SG underwent the FICB combined with laryngeal mask general anesthesia (LMA), and the CG underwent LMA. The perioperative extubation time, the total dose of anesthesia, the postoperative language statement time, and the recovery time index were recorded. The incidence of adverse reactions of the two groups was recorded. The pain scores at 6 h, 24 h, and 48 h after surgery were evaluated using the visual analog scale pain score (VAS). The cognitive functions of the two groups before surgery, 1 day after surgery, and 3 days after surgery were evaluated using a simple intelligence table (MMSE). Peripheral blood T lymphocyte subsets were determined using flow cytometry at 30 min before the anesthesia induction, 1 day after surgery, and 3 days after surgery. Results: The extubation time, the total dose of anesthesia, the time of speech presentation, the time of recovery, and the incidence of complications were lower in the SG than in the CG (P<0.05). The VAS scores of the SG and CG at 24 h and 48 h after the operation were lower than those at 6 h after the operation (P<0.05). The VAS scores of the SG were lower than the CG VAS scores at 6 h, 24 h, and 48 h after the operation (P<0.05). The MMSE scores of the SG and CG 1 day after surgery were lower than the preoperative MMSE scores and the MMSE scores 3 days after the operation (P<0.05). The MMSE scores of the SG were higher than the MMSE scores of the CG (P<0.05). The ratio of CD3(+), CD4(+), CD8(+) and CD4(+)/CD8(+) in the peripheral blood of the SG and CG were lower than they were before the induction of anesthesia and at 3 days after the operation (P<0.05). Conclusion: FICB combined with LMA is a viable anesthesia program in elderly FNF. It can reduce the amount of anesthetic used, make the recovery and postoperative statement times faster, achieve a better postoperative analgesic effect, and reduce postoperative complications, which can improve the cognitive and immunologic functions of patients to a certain extent.