To explore the effect of combined application of general anaesthesia plus a single dose local iliac fascia block on total hip arthroplasty (THA).

Between February 2018 and February 2021, a total of 116 patients who were suitable for THA treatment and tolerant of the surgery for total hip arthroplasty at Meishan Hospital of Traditional Chinese Medicine were included in this study. Exclusion criteria: patients with other diseases, coagulation dysfunction, difficult to communicate, severe complications and a long history of analgesics. Patients were randomly divided into a control group (general anaesthesia) and a study group (general anaesthesia combined with single dose local iliac fascia block). The dosage of administered anaesthetic drugs, postoperative pain at rest and exercise, as well as mental and cognitive status and psychological status after surgery between the groups were compared by t test. Postoperative nausea and vomiting (PONV) and complications were compared between the two groups by chi square test.

In terms of medication, the dosage of sedative and analgesic drugs administered, including propofol, sufentanil and remifentanil, in the study group was less than that in the control group, with a statistically significant difference (t=33.275, 14.483, 4.4954, all P<0.05). Of the postoperative pain, the visual analogue scale (VAS) score of the study group was significantly lower, and the difference was statistically significant (t=14.904, 5.114, both P<0.05), which showed that the patients in the study group suffered less pain. After surgery, scores of intergroup mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) in both groups decreased than that before surgery, and the differences were statistically significant (control group: t=24.182, 29.142; study group: t=16.045, 10.913; all P<0.05). Postoperative intergroup comparison of MMSE and MoCA scores were higher in the study group (t=3.589, 6.606, both P<0.05). Significant changes in self-rating anxiety scale (SAS) and self-rating depression scale (SDS) scores were noticed between the two groups before and after surgery, and the differences were statistically significant (control group: t=20.205, 14.137; study group: t=29.438, 24.176; all P<0.05). The scores of all after surgery observed items in the study group were higher than those in the control group (t=3.145, 2.862, both P<0.05). The study group had a lower incidence of PONV than the control group (3.4% vs 15.5%), with a statistically significant difference (χ²=4.921, P<0.05). Finally, there was no statistically significant difference in the incidence of complication (P>0.05).

The combined applications of general anaesthesia and single dose local iliac fascia block in total hip arthroplasty can not only significantly reduce the drug administration and the risk of complications, but also relieve pain, effectively reduce nerve injury and safeguard the cognitive function of patients.