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      Effect of fascia iliaca compartment block combined with ropivacaine on post-operative outcomes in elderly patients undergoing hip fracture repair

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          Abstract

          Objective:

          To explore the effect of fascia iliaca compartment block (FICB) in combination with ropivacaine on post-operative outcomes in elderly patients undergoing hip fracture (HF) repair.

          Methods:

          Retrospective analysis included data of 111 elderly patients who underwent HF surgery with FICB in Changxing County People’s Hospital from October 2018 to October 2022. Observation group received 0.25% ropivacaine combined with FICB (n=52), and the control group was administered an intravenous injection of parecoxib sodium (n=59). Baseline characteristics of the patients, and indexes such as mean arterial pressure (MAP), heart rate (HR), and visual analogue scale (VAS) pain scores, were collected at one-, six-, 12- and 24-hours past surgery, both at rest and after passive movement.

          Results:

          VAS scores, MAP and HR at rest and after a passive movement in both groups were comparable before the surgery. VAS sores were significantly lower in the observation group at one-, six-, 12- and 24-hours after the surgery (P<0.05). Postoperative MAP in the observation group (80.83 ± 8.31) was significantly lower compared to the control group (95.29 ± 8.45 (t = -9.0659, p < 0.0001). Similarly, HR of the observation group was significantly lower one-hour post-surgery both at rest (t = -2.0468, p = 0.0431) and after passive movement (t = -6.0625, p < 0.001), and at all subsequent time intervals after the passive movement (P<0.05).

          Conclusions:

          Ropivacaine combined with FICB was associated with improved post-operative outcomes such as lower post-surgery VAS scores, MAP and HR compared to the intravenous injection of parecoxib sodium.

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          Most cited references29

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          World-wide Projections for Hip Fracture

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            Ropivacaine: A review of its pharmacology and clinical use

            Ropivacaine is a long-acting amide local anaesthetic agent and first produced as a pure enantiomer. It produces effects similar to other local anaesthetics via reversible inhibition of sodium ion influx in nerve fibres. Ropivacaine is less lipophilic than bupivacaine and is less likely to penetrate large myelinated motor fibres, resulting in a relatively reduced motor blockade. Thus, ropivacaine has a greater degree of motor sensory differentiation, which could be useful when motor blockade is undesirable. The reduced lipophilicity is also associated with decreased potential for central nervous system toxicity and cardiotoxicity. The drug displays linear and dose proportional pharmacokinetics (up to 80 mg administered intravenously). It is metabolised extensively in the liver and excreted in urine. The present article details the clinical applications of ropivacaine and its current place as a local anaesthetic in the group.
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              Anaesthetic care of patients undergoing primary hip and knee arthroplasty: consensus recommendations from the International Consensus on Anaesthesia-Related Outcomes after Surgery group (ICAROS) based on a systematic review and meta-analysis

              Evidence-based international expert consensus regarding anaesthetic practice in hip/knee arthroplasty surgery is needed for improved healthcare outcomes.
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                Author and article information

                Journal
                Pak J Med Sci
                Pak J Med Sci
                Pakistan Journal of Medical Sciences
                Professional Medical Publications (Pakistan )
                1682-024X
                1681-715X
                Mar-Apr 2024
                : 40
                : 4
                : 757-762
                Affiliations
                [1 ]Junshi Li, Department of Anesthesiology, Changxing County People’s Hospital, Changxing Country, Huzhou 313100, Zhejiang Province, P.R. China
                [2 ]Hui Chen, Department of Anesthesiology, Changxing County People’s Hospital, Changxing Country, Huzhou 313100, Zhejiang Province, P.R. China
                [3 ]Jianfeng Zuo, Department of Anesthesiology, Changxing County People’s Hospital, Changxing Country, Huzhou 313100, Zhejiang Province, P.R. China
                [4 ]Xiping Zhang, Department of Anesthesiology, Changxing County People’s Hospital, Changxing Country, Huzhou 313100, Zhejiang Province, P.R. China
                Author notes
                Correspondence: Xiping Zhang, Department of Anesthesiology, Changxing County People’s Hospital, 66 Taihu Middle Road, Changxing Country, Huzhou 313100, Zhejiang Province, P.R. China. Email: homeandrain@ 123456163.com
                Article
                PJMS-40-757
                10.12669/pjms.40.4.8283
                10963986
                38544994
                e9e93981-32d0-49b5-88a0-282eb3842c40
                Copyright: © Pakistan Journal of Medical Sciences

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 15 May 2023
                : 05 June 2023
                : 22 September 2023
                : 21 November 2023
                : 17 December 2023
                Categories
                Original Article

                fascia iliaca compartment block,hip fracture,ropivacaine

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