Analysis of impact of ultrasound-guided nerve block combined with laryngeal mask general anesthesia on postoperative adverse reactions,hemodynamics and recovery quality in elderly patients undergoing lower limb fracture surgery
Objective To study the impact of ultrasound-guided nerve block combined with laryngeal mask general anesthesia on postoperative adverse reactions,hemodynamics and recovery quality in elderly patients undergoing lower limb fracture surgery.Methods 76 elderly patients with lower limb fractures surgery were included.According to the differences in anesthesia methods,patients were divided into a control group and an observation group,each with 38 cases.The control group received simple laryngeal mask general anesthesia,and the observation group received ultrasound-guided nerve block combined with laryngeal mask general anesthesia.Comparison was made on hemodynamics[heart rate(HR),respiratory rate(RR),mean arterial pressure(MAP),blood oxygen saturation(SpO2)]levels before anesthesia(T0),laryngeal mask insertion(T1),skin resection(T2),and laryngeal mask removal(T3),numerical rating scale(NRS)score,Ramsay sedation score,mini-mental state examination(MMSE)score,recovery quality(awakening time,laryngeal mask removal time,and anesthesia recovery room retention time),postoperative adverse reactions between the two groups.Results At T0,there was no significant difference in HR,RR,MAP and SpO2 between the two groups(P>0.05).At T1,the observation group had significantly lower RR of(21.16±1.83)times/min than(24.64±2.05)times/min in the control group(P<0.05),but there were no significant differences in HR,MAP and SpO2(P>0.05).At T2,the observation group had HR of(72.18±7.65)beats/min,RR of(22.30±2.10)times/min,MAP of(78.82±11.23)mm Hg(1 mm Hg=0.133 kPa),which were lower than(96.57±8.93)beats/min,(26.53±3.14)times/min and(104.74±10.39)mm Hg in the control group;the observation group had higher SpO2 of(98.45±1.26)%than(97.65±1.32)%in the control group;the difference was significant(P<0.05).At T3,the observation group had HR of(88.25±8.76)beats/min,RR of(18.79±1.63)times/min,MAP of(93.16±10.87)mm Hg,which were significantly lower than(111.66±12.34)beats/min,(22.50±2.41)times/min and(111.83±11.53)mm Hg in the control group(P<0.05),but there was no significant difference in SpO2 groups(P>0.05).10 min before extubation,NRS score and MMSE score in both groups were lower than those before anesthesia,while the Ramsay sedation score were higher than that before anesthesia.The differences were significant(P<0.05).Compared with the control group,the observation group had lower NRS score,higher Ramsay sedation score and MMSE score 10 min before extubation,and the difference was significant(P<0.05).The awakening time in the observation group was(5.09±1.01)min,the laryngeal mask removal time was(10.36±2.20)min,and the anesthesia recovery room retention time was(40.75±6.52)min,which were shorter than(6.86±1.33),(20.94±3.72),and(51.43±10.16)min in the control group,and the difference was significant(P<0.05).Compared with the control group(21.05%),the incidence of postoperative adverse reactions was lower in the observation group(2.63%),and the difference was significant(P<0.05).Conclusion Ultrasound-guided nerve block combined with laryngeal mask general anesthesia can reduce the impact on hemodynamics and cognitive function in elderly patients undergoing lower limb fracture surgery,exert good sedative and analgesic effects,and improve the recovery quality and safety.
Old ageLower limb fracture surgeryUltrasound guidanceNerve blockLaryngeal mask general anesthesia
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