Comparison Of The Anaglesic Effects Of Two Kinds Of Analgesia Models After Hip Joint Replacement

Objective:To investigate the analgesic effect of lumbar plexus block and intravenous self-control in artificial hip replacement surgery,and the perioperative hemodynamic changes.Methods:Twenty-one patients undergoing selective unilateral hip replacement at our institution were divided into intravenous patient-controlled analgesia group(A group)and lumbar plexus block group(B group).After entering the operating room,all patients were given routine monitoring(ECG,non-invasive blood pressure,pulse oxygen saturation)and invasive arterial pressure monitoring,open up the upper extremity veins.B group received lumbar plexus block with 0.5 percent ropivacaine 10ml,followed by general anesthesia.A group application general anesthesia.The anesthetic induction was given to dexamethasone 10mg,diazocin 10mg,midazolam 2mg,shunazurium 0.15?0.2 mg/kg,etomidate 0.2-0.4 mg/kg,the endotracheal tube was given 3 minutes after the oxygen denitrification mask was pressurized and inhaled.Propofol,Rifentanil hydrochloride,shunazurium and inhaled anesthetic sevoflurane were given during anesthesia for both groups.Observe and record the operation time.Observe and record the score of the patient's visual analogue method(VAS)at resting state after surgery 3h(T4),6h(T5),12h(T6),24h(T7),48h(T8).Observe and record the scores of visual analogue(VAS)with T6.T7 and T8 at the time of exercise,postoperative adverse reactions.Observed and record into the operating room(TO),induction of general anesthesia(T1),at the beginning of the operation(T2),anesthesia recovery(T3),after surgery 3h(T4),6h(T5),12h(T6),24h(T7),48h(T8),the patient's systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR).Results:The operating time in group A was73.90±12.93,the operating time in group B was 73.64±2.8,no statistically significant difference in operation time between the two groups(P>0.05).In the resting state,two groups of patients 3h after the operation with no significant pain,VAS at 6h,12h,24h and 48h after surgery in group B were 0.5±0.6,1.3±0.6,1.8±0.6,0.7± 1.2.VAS at 6h,12h,24h and 48h after surgery in group A were 2.2±0.7,4.1±0.9,5.0±0.7,1.3±0.7.The VAS of the group B was significantly lower than the group A with 6h?12h?24h and 48h after the operation(P<0.05).In the activity state,VAS at 12h,24h and 48h after surgery in group B were 2.1±0.5,2.6±0.5,2.0±0.6.VAS at 12h,24h and 48h after surgery in group A were 6.3±0.7,6.6±0.6,2.8±0.7.The VAS of the group B was significantly lower than that of the group A with 12h,24h and 48h after the operation(P<0.05).Systolic blood pressure,diastolic blood pressure and heart rate were stable in the group B(P<0.05).In the group A,one patient experienced nausea and vomiting after surgery.Conclusion:In hip replacement surgery,lumbar plexus nerve block compound general anesthesia compared with general anesthesia,postoperative analgesia is better than intravenous analgesia,perioperative hemodynamic stability is more stable.