| Background:Total hip arthroplasty(THA)is a common operation in the elderly.the age of the geriatric population is rising and consequently,so is the rate of comorbidity.At this time,almost all of the anesthsia method in geriatric’s THA are general anesthsia,epidural anesthsia.but Several studies have shown that tranditional metheds of anesthsia can effect our circulatory system,respiratory system,and also have negative affects in early funtion rehabilitation after THA.However,there are few studies on the combination of lumbar plexus and sciatic nerve block in direct aterior minimally invasive surgery.The purpose of this study was compared nerve block anesthsia(lumbar plexus-sciatic nerve block)and combined spinal and epidural anesthesia to evaluate the effect of lumbar plexus-sciatic nerve block in DAMIS.Methods:Between March 2015 and December 2016,a total of 81 patients over the age of 75 were divided into two groups:41 patients received nerve block anesthsia(combined lumbar plexus and sciatic nerve block),and 40 patients received spinalepidural anesthesia(CSEA).blood loss,operating time,postoperative feeding time and down time were noted.transfusion rate and postoperative untoward reaction were also recorded.Results:The postoperative feeding time was lower in the nerve block anesthsia group(2.78±0.72h)than in the CSEA group(6.36±0.58h)(P<0.001).and the down time(47± 4.6)in the experimental group also lower than the control group(70±6.8).the postoperative adverse reaction were significantly less in the combined spinal and epidural anesthesia group.There were no significant differences in blood loss or operating time among the groups.Conclusion:The lumbar plexus and sciatic nerve block group is more effective for reducing postoperative feeding time,the down time and the postoperative adverse reaction compared to the CSEA group in direct anterior minimally invasive surgery and there will reduce the rate of dislocation,incision length and improve patients satisfaction by DAMIS. |
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