Ultrasound-guided continuous iliofascial block with ropivacaine is superior to intravenous infusion of sufentanil for the treatment of delirium in elderly patients after hip arthroplasty: A retrospective cohort study

Abstract

Abstract Background Hip arthroplasty is often accompanied by severe postoperative pain in elderly patients and increases the incidence of delirium. The aim of this study was to compare the effects of sufentanil intravenously with iliofascial blocks using ropivacaine on postoperative analgesia and cognitive function. Methods Clinical data were retrospectively collected from 682 elderly patients who underwent hip arthroplasty and were divided between intravenous pumped sufentanil or continuous iliofascial block using ropivacaine. All patients were treated with general anesthesia, and the main indicators were the incidence of delirium, pain scores and postoperative complications within 5 days postoperatively. Results The incidence of postoperative delirium and the duration of delirium were lower in group B than in group A (P < 0.05). Comparison of the postoperative MMSE scores showed that the MMSE scores in group A were lower than those in group B (P < 0.05). In a comparison of the overall data of patients with and without postoperative delirium, the NRS scores of patients with postoperative delirium were higher than those without postoperative delirium on the first, third, and fifth postoperative days at rest (P < 0.05). Conclusions In elderly patients, after total hip arthroplasty, ultrasound-guided continuous iliofascial block was more effective than intravenous sufentanil in relieving postoperative pain and helped to reduce the incidence of postoperative delirium, as well as reducing some of the adverse prognoses.