ObjectiveThe objective of this article is to make a comparison of the anesthetic effects of the inside and outside fascia iliaca compartment block (FICB) in total hip arthroplasty (THA) and to study the effect of the different approaches of the FICB on postoperative cognitive dysfunction (POCD) and serum inflammatory cytokines in THA patients.MethodsA total of 60 patients who received THA treatment from January 2021 to December 2021 were divided into two groups, namely, Inside group (inside approach of the FICB) and Outside group (outside approach of the FICB), according to the different approaches of the FICB. Forty-eight hours after surgery, we compared the use of ropacaine dosage, visual analogue scale (VAS) score, the use of patient-controlled analgesia (PCA), mini-mental state examination (MMSE) score, the incidence of POCD, and the serum levels of IL-1, IL-6. Secondary indicators include surgical indicators and the quality of anesthesia cannula.ResultsThe ratio of re-fix the catheter, intubation time, and the use of ropacaine dosage at 48 h after surgery in the Outside group were significantly higher than that in the Inside group (p < 0.05), while the depth of cannulation in the Outside group was significantly lower than that in the Inside group (p < 0.05). VAS scores were comparable between the Inside and the Outside groups, except at 24 h after surgery. The use of PCA from 24 to 48 h after surgery in the Outside group was significantly higher than that in the Inside group (p < 0.05). The MMSE score and the incidence of POCD in the Outside group were higher than that in the Inside group. At the same time, the serum IL-1β levels at 1 and 6 h after surgery and the serum IL-6 levels at 1, 6, 24, and 48 h after surgery in the Outside group were significantly higher than that in the Inside group (p < 0.05).ConclusionCompared with the outside approach of the FICB, the inside approach of the FICB has better anesthetic effect, better postoperative analgesia, fewer postoperative analgesics, lower incidence of POCD, and lower serum cytokines during the treatment of THA patients.

Angioneurotic headache is a common headache type in clinical treatment. At present, patients with nervous headache are mainly treated with oral western medicine in clinic, but it is usually difficult to obtain the ideal effect. In this study, we analyzed the effects of continuous lidocaine infusion through an ultrasound-guided cervical sympathetic ganglia (SG) catheter on cerebral hemodynamics and thermal imaging characteristics of head and neck in patients with angioneurotic headache and explored the clinical feasibility of this scheme. The results show that continuous infusion of lidocaine under ultrasound-guided SG catheterization can alleviate headache in patients with angioneurotic headache, which may be related to improving cerebral hemodynamics.

The aim of this study was to explore the application value of paravertebral nerve block (PVB) based on goaloriented nano-liquid in patients undergoing thoracotomy. In this study, ordinary starch granules were applied to prepare starch nano-spheres by reverse phase suspension cross-linking polymerization. Then, there is an analysis on the influence of pH value, stirring speed, and reaction time on the particle size and swelling degree of starch nano-spheres. The infrared spectroscopy, scanning electron microscope, X-ray diffraction, and laser particle size were employed to analyze the particle size, characterization, and structure of starch and nanostarch microspheres in turn. 102 patients with lung cancer undergoing elective thoracotomy were selected as the research objects and rolled into a PVB group (group A) and a goal-oriented nano-liquid combined PVB (group B). The heart rate (HR), mean arterial pressure (MAP), stroke volume (SV), cardiac output index (CI), and cardiac output (CO) changes of patients from the two groups were observed at each time point. The changes of VAS scores for pain in patients from the two groups were analyzed at quietness and cough at the 3rd hour and 6th hour after surgery, as well as the incidence of postoperative complications. The results showed that when pH = 9, rotation speed was 1,000 rpm/min, and reaction time was 1 hour, the particle size of starch nano-particles was the smallest (260.74±8.78 nm), which were spherical, and the vibration absorption peak of glycosidic bond C–O–C was about 1,000 cm−1. Moreover, there were obvious diffraction peaks at 15°, 17°, and 24°. At T1, T2, and T4, the MAP value of patients from group A was dramatically higher than the value of group B (P < 0.05), and the HR value of patients in group A was also greatly higher than that of group B at T3, T2, and T1 (P < 0.05). The VAS scores of patients from group A at quietness and cough at the 6th hour after surgery increased greatly in contrast to the scores of group B (P < 0.05). In addition, the proportion of patients in group A with postoperative complications of hypertension, chills, restlessness, and delayed recovery was markedly higher than that of group B (P < 0.05). It indicated that the goal-oriented nano-starch liquid combined with PVB had little influence on the hemodynamics of patients undergoing thoracotomy, and the postoperative VAS scores and complications were reduced.