Discussion
fracture, pain
ADVERSE EFFECTS
The trial revealed that the FICB group had a longer duration of analgesia and lower grade of muscle strength compared with the control group. The QoR score of the FICB group at 24 h after surgery was higher than that of the control group, and there was no statistically significant difference between the two groups at 48 h after surgery. Meanwhile, the lowest MAP before spinal anesthesia was significantly lower in the FICB group than in the control group. The time to perform spinal anesthesia was shorter and the VAS score was lower in the FICB group. There is no significant between-group difference in the onset time and duration of spinal anesthesia.It is beneficial to complete FICB before spinal anesthesia. Proper positioning of the lumbar spine is a prerequisite for successful neuraxial anesthesia, but it is difficult to achieve due to the pain at the fracture site [Spinal anesthesia is usually judged by the sensation of the skin. The onset of anesthesia was defined as when the level of anesthesia on the operated side reached T10, as the T10 level is the required level of anesthesia for hip arthroplasty surgery [The longer duration of analgesia in the FICB group should be directly attributed to the FICB rather than to a prolongation of the analgesic effect of spinal anesthesia. Previous trials have shown that the use of FICB can provide effective postoperative analgesia for patients undergoing hip arthroplasty and facilitate the maintenance of hemodynamic stability [The QoR-15 provides a valid, extensive, and efficient evaluation of postoperative QoR [We found in our research that FICB may also have adverse effects. The trial revealed that patients in FICB group had lower postoperative muscle strength in the limb on the side of surgery than in control group. Assuming the absence of the effect of FICB, when the muscle strength of the contralateral lower limb recovered to grade 4, the muscle strength of the operated side should have recovered to grade 4 as well. This suggested that the FICB decreased the quadriceps muscle strength even after the effect of spinal anesthesia on muscle strength had disappeared. This finding is similar to a previous one in which the FICB group injected with 40 mL of 0.2% ropivacaine showed lower postoperative quadriceps muscle strength and a higher risk of falls than the control group injected with normal saline [Previous trials have concluded that FICB does not affect the blood pressure in patients [