Discussion
peripheral nerve block, pain, arthroplasty, ’ muscle strength decreased, non-fracture
PATHOPHYSIOLOGY, DEEP VENOUS THROMBOSIS, POSTOPERATIVE COMPLICATIONS
FICB is a technique of injecting the local anesthetic into a triangular space between the FI and the edge of the IM, which can effectively block the FN, LFCN, ON, and genitofemoral nerve (GFN). The block of FN and LFCN helps relieve the pain of hip arthroplasty. Depending on the puncture point choice, FICB has various operation methods [The up-and-down method is currently recognized as a classical method for determining the 50% effective dose or concentration of drugs. The advantage is that it requires a small number of patients and can save many samples. It can also reflect the situation of any point in the dose-response curve [It is worth noting that in our study, the muscle strength of quadriceps femoris before S-FICB and 30 min after S-FICB in non-fracture patients was also included in the observation index. The results showed that only 2 of the 31 subjects’ muscle strength decreased at 30 min after S-FICB. And they both received 34.8ml of local anesthetic. The volume of 0.33% ropivacaine used in our study has little inhibition on lower limb muscle strength in patients undergoing hip arthroplasty. And this is positive for patients to participate in functional exercise, get out of bed as soon as possible and even prevent postoperative complications such as deep venous thrombosis.This study also has some limitations. First, 0.3% ~ 0.5% ropivacaine is the recommended concentration range for peripheral nerve block. Single-point FICB often requires a larger volume of the local anesthetic to achieve a better blocking effect. And most of the patients included in this study are elderly patients. They are more sensitive to local anesthetics due to changes in their pathophysiology. Therefore, this study chose a lower concentration of ropivacaine. Considering the convenience of clinical operation, we finally chose 0.33% ropivacaine. The blocking effect of other concentrations of ropivacaine in different crowds needs further study. Second, the efficacy of the ON block in analgesia after hip arthroplasty is uncertain. Previous scholars [