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Comparison of the Selective Lumbar Plexus Combined with Sciatic Nerve Block and Lumbar Plexus Combined with the First Posterior Sacral Foramen Block in Hip Replacement for the Elderly |
JI Miao |
Department of Anesthesiology, Anhui Provincial Hospital of traditional Chinese medicine, Anhui, Hefei 230000, China |
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Abstract Objective To compare the application of selective lumbar plexus combined with sciatic nerve block and lumbar plexus combined with the first posterior sacral foramen block in hip replacement for the elderly. Methods Sixty elderly patients who needed to be treated with hip replacement were divided into Group A (lumbar plexus and sciatic nerve block) and B group (lumbar plexus combined with the first posterior sacral foramen block) according to different anesthesia methods, 30 cases in each group. The hemodynamic changes, the success rate of block, anesthetic effect and adverse reactions in the two groups were recorded. Results There was no significant difference in HR, SBP and DBP in the Group A at different time points (P>0.05). In the Group B, 10 min ,20 min after the start of operation, the SBP decreased compared with the previous block, and the difference was significant (P<0.05); There were no significant differences in HR and DBP at each time point (P>0.05). 30 min after injection, skin needling sensation block success rate in the lumbosacral plexus nerve skin area of the Group A was 98%~100%, and that of the Group B was 92%~100%. The excellent rate of anesthesia in the Group A was 100%, higher than that in the Group B, but there was no significant difference between the two groups (P>0.05) (93.3%). No local anesthetic poisoning occurred in the two groups. Conclusion Compared with the first posterior sacral foramen block, HR, SBP and DBP of patients receiving lumbar plexus and sciatic nerve block are relatively stable, the success rates of different block levels are higher with better anesthetic effect. It is a better choice for hip replacement.
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Received: 07 January 2017
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