Effects Of Ultrasound-guided Lumbar Plexus And Sacral Plexus Nerve Block Combined With General Anesthesia On Postoperative Delirium In Elderly Patients Undergoing Hip Replacement Surgery

ObjectiveTo investigate the effects of ultrasound-guided LBP combined with general anesthesia on POD in elderly patients undergoing hip replacement surgery,and to provide reference for the selection of clinical anesthesia.MethodsFrom February 2019 to August 2020,80 elderly patients with femoral neck fracture undergoing elective hip replacement were collected in our hospital,including43 males and 37 females,aged 65 to 81 years old,with ASA II or grade III.They were randomly divided into ultrasound-guided LBP combined with general anesthesia group(h group)and general anesthesia group(q group),with 40 cases in each group,and laryngeal mask was used to maintain ventilation,and intravenous self-controlled analgesia was given after surgery.Record data:(1)Intraoperative dosage of general anesthetics,blood loss,infusion volume,number of blood transfusions,cyclic fluctuation condition,extubation time,PCA frequency within 24 h after surgery,first time of getting out of bed time and discharge time;(2)Visual analogue scale(VAS)was used to assess postoperative pain;(3)The fuzzy consciousness assessment scale was used to measured whether POD occurred in preoperative(D0),postoperative day1(D1),day 3(D3),and day 7(D7)and records were recorded.(4)Venous blood were collected at D0,D1,D3,D7 to measure S100β protein.ResultsThere were no significant differences in general information,intraoperative blood loss,fluid infusion volume,number of blood transfusions and operation time between the two groups(P > 0.05).The amount of intraoperative anesthetic,circulation fluctuation,extubation time,PCA times,VAS score,first time of getting out of bed and discharge time in group h,were significantly lower than those in group q(P < 0.05).After operation the level of S100β protein,CAM score and POD incidence in group h were lower than in group q(P<0.05).ConclusionUltrasound-guided lumbar plexus and sacral plexus nerve block combined with general anesthesia can reduce anesthesia dose,pain degree,circulation fluctuation,degree of brain injury,POD incidence in elderly patients undergoing surgery,and promote rapid postoperative recovery.