Effect of different analgesic treatments on the pulmonary function in elderly hip fracture patients: A prospective study

BACKGROUND: To investigate the effect of different analgesic methods on lungs in elderly patients with hip fractures. METHODS: A prospective study was conducted on 78 elderly hip fracture patients undergoing spinal anesthesia for surgery, where 3 analgesic methods were used: postoperative Patient-controlled intravenous analgesia pump (PCIA) (group I), pre and postoperative PCIA (group II), and preoperative fascia iliaca compartment block (FICB) + postoperative PCIA (group III). The following indicators were monitored at admission (T(1)), on the day of surgery before anesthesia (T(2)), and 7 days after surgery (T(3)): heart rate (HR), respiratory rate (RR), forced expiratory volume during the first second, arterial partial pressure of oxygen (PaO(2)) and carbon dioxide (PaCO(2)), C-reactive protein (CRP), and interleukin 6 (IL-6). Pulmonary complications such as pulmonary atelectasis and respiratory insufficiency were analyzed. RESULTS: The HR, RR, forced expiratory volume during the first second, PaO(2), PaCO(2), IL-6, and CRP levels at T(1) after fracture did not significantly differ among the 3 groups (P > .05). After different analgesic treatments post-admission, all indicators at T(2) were significantly higher in group I than in groups II and III (P < .05), while there was no significant difference between groups II and III (P > .05). At T(3), there were no significant differences in RR, HR, PaO(2), PaCO(2), and CRP levels among the groups (P > .05), but IL-6 levels at T(3) were significantly higher in group I than in groups II and III (P < .05). CONCLUSION: The use of effective pain relief during surgery can help protect the lung function of elderly patients with hip fractures. When using PCIA with FICB before surgery, respiratory performance may be better protected compared to using unsustained analgesia. This could be due to a decrease in the levels of inflammatory markers such as CRP and interleukin-6.