ObjectiveTo investigate the analgesia effects of preoperative analgesia employing ultrasound-guided femoral nerve block combined with nalbuphine on postural pain before intraspinal anesthesia in patients with hip fracture. MethodsA total of 90 patients with hip fracture were selected and assigned to nalbuphine group (N group), femoral nerve block group (F group), and femoral nerve block combined with nalbuphine group (FN group) by the random number table method, with 30 cases in each group. All patients were intravenously injected flurbiprofen axetil 50 mg, 3 times per day after admission. After entering the operation room, the N group was intravenously dripped nalbuphine 0.2 mg/kg, whereas the F group received ultrasound-guided combined with nerve stimulator femoral nerve block, and the patients were injected 0.375% ropivacaine 15 mL; meanwhile, the FN group received the analgesic solution of the F and N groups simultaneously. The static and dynamic VAS scores, mean arterial pressure (MAP), heart rate (HR) and peripheral oxygen saturation (SpO2) were recorded before preoperative analgesia implementation (T0), after preoperative analgesia implementation (T1), 5 min after crossing the bed (T2), and 5 min after side lying (T3). The incidence of preoperative analgesia adverse reactions, including nausea, vomiting, dizziness, excessive sedation and respiratory depression, as well as the incidence of analgesic failure and the conditions of related complications were compared between the three groups. ResultsThere were statistically significant differences in static and dynamic VAS scores between the three groups, and both static and dynamic VAS scores had a tendency to change with time; moreover, there was interaction between grouping and time (all P＜0.05); the static VAS score in T3 of the FN group was significantly lower than that of the N and F groups (P＜0.05), whereas no statistically significant differences were interpreted in the rest of the time (all P＞0.05). The dynamic VAS scores in T1, T2 and T3 of the FN group were significantly lower than those of the N and F groups (all P＜0.05). There were statistically significant differences in MAP and HR between the three groups, the indicators mentioned above had a tendency to change with time, and there was interaction between grouping and time (all P＜0.05). There was no statistically significant difference of SpO2 at each time point between the three groups (all P＞0.05). No adverse reactions including nausea, vomiting, dizziness, excessive sedation and respiratory depression occurred in the three groups. No nerve block related complications including anesthetic toxicosis, hematoma, etc. occurred in the F and FN groups. There was no statistically significant difference of preoperative analgesia failure rate between the three groups (P＞0.05). ConclusionUltrasound-guided femoral nerve block combined with nalbuphine is safe and effective for postural pain before intraspinal analgesia in patients with hip fracture, and it is a more reliable preoperative analgesic method.

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