Anesthetic Effect Observation Of Modified Lumbar Plexus Block For Total Hip Arthroplasty In Elderly Patients

Objective:To explore the anesthetic effect of ultrasound-guided modified lumbar plexus block for total hip arthroplasty?THA?in elderly patients.Methods:Sixty elderly patients,24 males and 36 females,aged 75⁸9 years,ASA?or?,undergoing THA were randomized into two groups with 30 cases in each group:ultrasound-guided modified lumbar plexus block?group A?and ultrasound-guided conventional lumbar plexus block?group B?.The visual analogue scale?VAS?scores were recorded at the time of entering into the operating room?T₀?,positioning change?T₁?,skin incision?T₂?,5 minutes after the surgery?T₃?,12 hours after operation?T₄?,24 hours after operation?T₅?;the patients satisfaction ratings for anesthesia were recorded;the dose of sufentanil was recorded.Observing and recording the values of the MAP and HR at the time of entering into the operating room?T?₀?,5 minutes after anesthesia?T?₁?,skin incision?T?₂?,30 minutes after the operation began?T?₃?,and 5minutes after the surgery?T?₄?.The adverse reactions of local anesthetic intoxation,dizziness,nausea,vomiting,bilateral anesthesia,postoperative urinary retention were recorded.Results:?1?anesthesia efficacyDuring the surgical incision?T2?,the VAS score in group A was lower than that in group B?P<0.01?.There were no significant differences on VAS scores between the two groups at the other time points?P>0.05?.Anesthesia satisfaction rating in group A was better than that in group B?P<0.01?.The dose of sufentanil in group A was less than that in group B?P<0.01?.?2?hemodynamic indicesThere were no significant differences in MAP and HR between the two groups at the corresponding time points in group A and group B?P>0.05?.In group A,MAP and HR at T?₀ and T?₂ were compared with T?₁ respectively,the values of MAP and HR at T?₂ were lower than that at T?₁?P<0.01?,there was no significant difference between T?₀ and T?₁?P>0.05?.In group B,there were no significant differences in MAP and HR between T?₀ and T?₂ in comparison with T?₁?P>0.05?.?3?the incidence of complicationsThere was no significant difference in the incidence of adverse reactions between the two groups.Conclusions:Ultrasound-guided modified lumbar plexus block can more effectively reduce the intraoperative dose of sufentanil,and with better analgesia and higher satisfaction of anesthesia during surgery than that of conventional lumbar plexus block.