Effects of ultrasound‑guided pericapsular nerve group block in combination with laryngeal mask airway on anesthesia, postoperative analgesia, and recovery of elderly patients with femoral neck fracture undergoing closed reduction and internal fixation

TL;DR

Using ultrasound-guided PENGB with LMA anesthesia improves recovery and reduces pain in elderly patients with femoral neck fractures.

Contribution

Demonstrates that ultrasound-guided PENGB combined with LMA anesthesia improves hemodynamic stability and postoperative recovery in elderly FNF patients.

Findings

Study group had lower heart rate and blood pressure during surgery compared to the control group.

Study group showed reduced pain and faster recovery times post-surgery.

Ultrasound-guided PENGB with LMA anesthesia stabilizes hemodynamics in elderly FNF patients.

Abstract

Femoral neck fracture (FNF) frequently occurs in the elderly. FNF is usually treated surgically, but patients often have comorbidities, which make the surgery complicated and increase the intraoperative risk.

We aimed to assess the effects of ultrasound‑guided pericapsular nerve group block (PENGB) coupled with laryngeal mask airway (LMA) general anesthesia on anesthetic efficacy in elderly patients suffering from FNF undergoing closed reduction and internal fixation (CRIF), as well as their postopera‑ tive analgesia and rapid recovery.

Control group (n = 47) and study group (n = 57) were established for FNF patients hospitalized between October 2022 and August 2023, based on different anesthesia modes. Ultrasound‑guided fascia iliaca compartment block (FICB) and LMA general anesthesia were offered to the control group, while the study group underwent ultrasound‑guided PENGB and LMA general anesthesia.

In comparison with the study group, heart rate (HR) and mean arterial pressure rose significantly in the control group at the time of skin incision, 20 minutes intraoperatively, and at the end of the surgery, and HR also increased when the patients entered a postanesthetic care unit (P <0.05). The study group, in comparison with the control group, exhibited reduced serum neuropeptide Y and substance P levels at 12 and 24 hours postoperatively, and lowered Visual Analogue Scale scores at various time points following the operation (P <0.05). In comparison with the control group, the study group had shorter postoperative eye‑opening, extubation, and ambulation times (P <0.05)

Ultrasound‑guided PENGB with LMA general anesthesia are effective in elderly patients with FNF undergoing CRIF, and can stabilize the intraoperative hemodynamic state.

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