Abstract: Objective To investigate the clinical effects of ultrasound-guided lumbar plexus block in elderly patients underwent femoral intertrochanteric fractures surgery. Methods Sixty elderly patients with aged 71 y-98 y old, body weight 52 kg -70 kg, ASAⅡ-Ⅲ grade undergoing elective unilateral hip fracture surgery, were equally randomized into the ultrasound-guided lumbar nerve block group (group UNB) and combined spinal epidural anesthesia group (group SEA). Systolic blood pressure(SBP),diastolic blood pressure(DBP), heart rate (HR) before anesthesia (T0), at 10 (T1), 30(T2), 60 min (T3) after anesthesia, anesthesia procedure time, establishment time, duration time, surgery time, bleeding and infusion volume during the operation were recorded. Anesthesia effects were evaluated. The incidence of adverse effects were recorded. Results SBP and DBP in group SEA at T1 and T2 were lower than that at T0 and T3, and than that at T1 and T2 in group UNB, and HR were faster than that at T0 and T3, and than that at T1 and T2 in group UNB(P<0.05). Anesthesia procedure time, surgery time and bleeding volume in two groups were not different significantly(P>0.05). Anesthesia establishment time (12.1±3.8) min and duration time (414±43) min in group UNB were longer than that (7.7±1.9) min and (192±23) min in group SEA(P<0.05). Infusion volume in group UNB[(978±182) ml] were less than that in group SEA[(1 360±297) ml](P<0.05). The excellent and good rates of anesthesia effect in two groups were both 100%. There were 4 cases (13%) of hypotension in the operation, 5 cases (17%) of urinary retention and 2 cases (7%) of nausea and vomiting after the operation in group SEA, and the incidence rate of adverse reactions was obviously higher than that of group UNB (3%)(P<0.05). Conclusions Ultrasound-guided lumbar plexus block in elderly patients can provide satisfactory anesthesia for femoral intertrochanteric fractures surgery with stable hemodynamic, longer analgesia maintaining time, and lower incidence rate of adverse reactions, so it is an ideal anesthetic option.
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