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| Effect of Ultrasound Combined with PNS on Anesthesia and Cognitive Function in Elderly Lower Extremity Orthopedic Surgery |
| JIANG Hong-mei, WANG Hai-tao |
| Department of Anesthesiology Baotou Central Hospital, Baotou City Inner Mongolia 014010 |
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Abstract 【Objective】To explore the application value of ultrasound combined with peripheral nerve stimulator (PNS) in lumbar plexus-sciatic nerve block anesthesia for elderly lower extremity orthopedics.【Methods】A total of 160 elderly patients undergoing lumbar plexus-sciatic nerve block anesthesia orthopedic surgery from our hospital were selected and randomly divided into two groups with 80 cases each. The observation group was anesthetized with lumbar plexus-sciatic nerve block under the guidance of ultrasound combined PNS; the control group was anesthetized with lumbar plexus-sciatic nerve block by PNS guidance. Hemodynamic indexes, MMSE scores and anesthesia-related indexes were compared between the two groups at different time points.【Results】There was no significant difference in the systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) between the two groups of patients before (T0) to 60min (T3) after block (P> 0.05) . The changes in SBP, DBP, and HR monitoring values of patients in the two groups over time showed significant fluctuations compared to the time of T0 in this group, and the differences were statistically significant (P<0.05). There were no significant difference in the MMSE scores between the two groups before anesthesia and at 12h, 24h and 72h after anesthesia (P>0.05). However, compared to the same group before anesthesia, the changes in MMSE scores of the two groups at 12h and 24h after anesthesia showed the pattern that decreased first and then increased (P<0.05). The onset time of sensory nerve and motor nerve block in the observation group was significantly lower than that in the control group (P<0.05). The maintenance time of sensory nerve and motor nerve block in the observation group was significantly longer than that in the control group (P<0.05).【Conclusion】In the elderly patients with lower extremity orthopedic surgery, the use of ultrasound combined with external PNS guidance in lumbar plexus-sciatic nerve block anesthesia is helpful to improve the rapid accuracy of positioning and prolong never block time. It does not show any impact on hemodynamic fluctuation and cognitive function comparing to PNS positioning alone.
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Received: 19 December 2018
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2020, Vol. 37 
