Application of Lumbar and Sacral Plexus Block Combined with Laryngeal Mask Anesthesia in Elderly Patients Undergoing Total Hip Arthroplasty
Objective To explore the application effect of posterior lumbar plexus block(LPB)compounded with laryngeal mask general anesthesia(LMGA)in elderly total hip arthroplasty(THA).Methods A total of 60 elderly patients who underwent THA at Nanyang City Central Hospital between January 2022 and August 2023 were selected and randomly assigned to either the study group(n=30)or the control group(n=30)using a randomized numerical table.The control group underwent LMGA,while the study group underwent LPB composite LMGA.The perioperative indexes,pain level,hemodynamics,cognitive function,and occurrence of adverse events were then compared between the two groups.Results The onset of anesthesia,extubation time,awakening time,time to get out of bed,and hospital stay were shorter in the study group than in the control group.These differences were statistically significant(P＜0.05).The visual analog scores(VAS)of the two groups decreased at 6 h,12 h,and 24 h postoperatively compared with those of the control group.Two hours postoperatively,the VAS scores of the study group were found to be lower than those of the control group at the same time period,with statistically significant differences(P＜0.05).Additionally,the study group exhibited higher heart rates(HR)at the time of laryngeal mask insertion(T1),skin incision(T2),and implantation of prosthesis(T3).The mean arterial pressure(MAP)at T2 was higher than that at T0,with statistically significant differences(P＜0.05).Furthermore,the heart rate(HR)and MAP at T1,T2,T3,and the end of the operation(T4)in the study group were higher than that at T0,with statistically significant differences(P＜0.05).Furthermore,HR and MAP at T1,T2,T3,and T4 were lower in the study group than in the control group,with a statistically significant difference(P＜0.05).Additionally,the scores of the Mini-mental State Examination(MMSE)at 1 d and 3 d postoperatively in the two groups decreased compared with the preoperative scores.However,MMSE scores at the postoperative concurrent period were higher in the study group than in the control group,and the difference was statistically significant(P＜0.05).Additionally,the incidence rate of adverse events in the study group(6.67%)was lower than that of the control group(30.00%),and the difference was statistically significant(P＜0.05).Conclusion The LPB composite LMGA has been demonstrated to improve anesthesia,shorten awakening and hospitalization times,reduce pain levels,have less impact on hemodynamics and cognitive function,and reduce the occurrence of adverse events in elderly patients undergoing THA.
lumbosacral and sacral plexus blocklaryngeal mask general anesthesiaelderly total hip replacement surgery
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