Effects of isobaric spinal anesthesia combined with different nerve block techniques on postoperative pain and complications in elderly patients undergoing proximal femoral nail antirotation: a retrospective observational study
- 1Department of Medical Records and Statistics, People’s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, Yinchuan, Ningxia, China
- 2Department of Anesthesiology, Yinchuan Second People’s Hospital, Yinchuan, Ningxia, China
- 3Department of Neurosurgery, People’s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, Yinchuan, Ningxia, China
Abstract
Objective: To explore the impacts of isobaric spinal anesthesia combined with different nerve blocks on postoperative pain, complications, satisfaction and perioperative comfort in elderly patients undergoing proximal femoral nail antirotation(PFNA).
Methods: A retrospective analysis was conducted on elderly PFNA patients enrolled from 2019 to 2021 in the Department of Traumatic Orthopedics at the People’s Hospital of Ningxia Hui Autonomous Region. Patients were divided into four groups: group S(simple isobaric spinal anesthesia), group S + FNB(spinal anesthesia plus femoral nerve block), group S + LFCN(spinal anesthesia plus lateral femoral cutaneous nerve block), group S + FICB(spinal anesthesia plus fascia iliaca compartment block). Primary outcomes were dynamic VAS scores at different postoperative time points, while secondary outcomes comprised postoperative complications and pain management indicators. All data were collected and statistically compared.
Results: A total of 191 elderly patients who underwent PFNA met the inclusion criteria. In group S, VAS scores on postoperative days 2 and 3 were lower than those at 1 day preoperatively, whereas in groups S + FNB, S + LFCN, and S + FICB, VAS scores on postoperative days 1, 2, and 3 were lower than preoperative values. In all four groups, VAS scores on postoperative days 2 and 3 were lower than those on postoperative day 1 (P < 0.05). On postoperative day 1, VAS scores in groups S + FNB and S + LFCN were lower than those in group S, while VAS scores in group S + FICB were significantly lower than those in groups S + FNB, S + LFCN, and S on postoperative days 1, 2, and 3 (P < 0.05). The incidence of postoperative nausea, vomiting, and pruritus was lower in group S + FICB than in group S (P < 0.05). The dose of sufentanil required for rescue analgesia was lower in groups S + LFCN and S + FICB than in group S, and lower in group S + FICB than in groups S + FNB and S + LFCN (P < 0.05). The number of patients requiring postoperative rescue analgesia was lower in group S + FICB than in groups S + FNB, S + LFCN, and S (P < 0.05). Postoperative satisfaction was higher in group S + FICB than in group S (P < 0.05).
Conclusion: Preoperative isobaric spinal anesthesia combined with fascia iliaca compartment block was associated with better postoperative pain relief, reduced adverse reactions, and improved perioperative comfort in elderly patients, and was more effective than other anesthesia strategies.
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BibTeX
@article{li2026effects,
title = {{Effects of isobaric spinal anesthesia combined with different nerve block techniques on postoperative pain and complications in elderly patients undergoing proximal femoral nail antirotation: a retrospective observational study}},
author = {Jingjing Li and Ning Ma and Yuan Zhao and Na Liang and Yanbin Zhao},
journal = {Frontiers in Medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1813736},
url = {https://doi.org/10.3389/fmed.2026.1813736},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Effects of isobaric spinal anesthesia combined with different nerve block techniques on postoperative pain and complications in elderly patients undergoing proximal femoral nail antirotation: a retrospective observational study
AU - Jingjing Li
AU - Ning Ma
AU - Yuan Zhao
AU - Na Liang
AU - Yanbin Zhao
PY - 2026
DA - 2026/10/12
JO - Frontiers in Medicine
DO - 10.3389/fmed.2026.1813736
UR - https://doi.org/10.3389/fmed.2026.1813736
AB - Objective: To explore the impacts of isobaric spinal anesthesia combined with different nerve blocks on postoperative pain, complications, satisfaction and perioperative comfort in elderly patients undergoing proximal femoral nail antirotation(PFNA). Methods: A retrospective analysis was conducted on elderly PFNA patients enrolled from 2019 to 2021 in the Department of Traumatic Orthopedics at the People’s Hospital of Ningxia Hui Autonomous Region. Patients were divided into four groups: group S(simple isobaric spinal anesthesia), group S + FNB(spinal anesthesia plus femoral nerve block), group S + LFCN(spinal anesthesia plus lateral femoral cutaneous nerve block), group S + FICB(spinal anesthesia plus fascia iliaca compartment block). Primary outcomes were dynamic VAS scores at different postoperative time points, while secondary outcomes comprised postoperative complications and pain management indicators. All data were collected and statistically compared. Results: A total of 191 elderly patients who underwent PFNA met the inclusion criteria. In group S, VAS scores on postoperative days 2 and 3 were lower than those at 1 day preoperatively, whereas in groups S + FNB, S + LFCN, and S + FICB, VAS scores on postoperative days 1, 2, and 3 were lower than preoperative values. In all four groups, VAS scores on postoperative days 2 and 3 were lower than those on postoperative day 1 (P < 0.05). On postoperative day 1, VAS scores in groups S + FNB and S + LFCN were lower than those in group S, while VAS scores in group S + FICB were significantly lower than those in groups S + FNB, S + LFCN, and S on postoperative days 1, 2, and 3 (P < 0.05). The incidence of postoperative nausea, vomiting, and pruritus was lower in group S + FICB than in group S (P < 0.05). The dose of sufentanil required for rescue analgesia was lower in groups S + LFCN and S + FICB than in group S, and lower in group S + FICB than in groups S + FNB and S + LFCN (P < 0.05). The number of patients requiring postoperative rescue analgesia was lower in group S + FICB than in groups S + FNB, S + LFCN, and S (P < 0.05). Postoperative satisfaction was higher in group S + FICB than in group S (P < 0.05). Conclusion: Preoperative isobaric spinal anesthesia combined with fascia iliaca compartment block was associated with better postoperative pain relief, reduced adverse reactions, and improved perioperative comfort in elderly patients, and was more effective than other anesthesia strategies.
SN - 2296-858X
ER -