Efficacy of ultrasound-guided femoral nerve block for preoperative analgesia in elderly patients with hip fracture

Objective To compare the efficacy of ultrasound-guided femoral nerve block and oral celecoxib for preoperative analgesia in elderly patients with hip fractures. Methods Sixty-eight elderly patients with hip fracture surgery treated at the 908th Hospital of Joint Logistics Support Force from January 2019 to June 2022 were selected and randomly divided into two groups: the experimental group (femoral nerve block) and the control group (oral celecoxib), with 34 cases in each group. The experimental group received a 20 mL 0.3% ropivacaine for femoral nerve block under ultrasound guidance, while the control group was given celecoxib capsules (0.2 g, twice daily). Visual analog scores (VAS) were compared between the two groups at 10 minutes before intervention, 30 minutes after intervention, 2 hours after intervention, and 10 minutes before surgery. Complications such as nausea, vomiting, dizziness, and adverse drug reactions were also recorded. Results There was no significant difference in VAS scores between the two groups before intervention (P＞0.05). In the experimental group, VAS scores gradually decreased over time (P＜0.05). In the control group, VAS scores at each time point after intervention were lower than before intervention, with a higher score 10 minutes before surgery (3.85±1.11) compared to 2 hours after intervention (3.24±1.02). The experimental group had lower VAS scores at all time points after intervention compared to the control group (P＜0.05). The incidence of adverse reactions in the experimental group was lower than that in the control group(17.6% vs41.2%, χ2=4.53，P＜0.05）. Conclusion Both ultrasound-guided femoral nerve block and oral celecoxib can alleviate preoperative pain in elderly patients with hip fractures, but ultrasound-guided femoral nerve block is safer and can sustain pain relief.