Observation on the effect of lumbar plexus block combined with general anesthesia on the dosage of anesthetic drugs in elderly patients undergoing fracture surgery
Objective To explore the effect of lumbar plexus block(LPB)combined with general anesthesia on the dosage of anesthetic drugs in elderly patients undergoing fracture surgery.Methods A total of 84 elderly patients with fracture surgery were selected and divided into a control group(general anesthesia)and an observation group(LPB combined with general anesthesia)according to random number table,with 42 cases in each group.Both groups were compared in terms of surgical indicators,opioid dosage,hemodynamic parameters and postoperative pain score at different time points[at the time of intubation(T0),at the time of surgical incision(T1),at the time of suturing the incision(T2),and at the time of admission to anesthesia awakening room for 0.5 h(T3)],and occurrence of adverse reactions.Results There were no significant differences in operation time,tourniquet time,infusion volume,surgical blood loss and urine volume between the two groups(P>0.05).However,the awakening time and extubation time of the observation group were(12.46±2.36)and(13.84±2.47)min,which were shorter than(18.45±3.25)and(22.25±4.16)min of the control group(P<0.05).The opioid dosage was(13.25±2.75)μg in the observation group and(36.25±5.71)μg in the control group;the observation group was significantly less than the control group(t=23.519,P=0.000<0.05).There were no significant differences in heart rate and mean arterial pressure between the two groups at T0(P>0.05).However,the heart rate and mean arterial pressure in the observation group were significantly lower than those in the control group at T1,T2 and T3(P<0.05).The pain scores of the observation group were(1.54±0.35),(1.78±0.45),(1.45±0.36)and(1.38±0.38)points at 2,12,24 and 48 h after surgery,which were lower than(2.81±0.61),(3.15±0.69),(3.02±0.65)and(2.75±0.49)points of the control group(P<0.05).The incidence of adverse reactions was 7.14%(3/42)in the observation group and 26.19%(11/42)in the control group;the observation group was lower than the control group(χ2=5.486,P=0.019<0.05).Conclusion Compared with general anesthesia,LPB combined with general anesthesia can not only better maintain hemodynamic stability during surgery,but also reduce the awakening time and extubation time,better alleviate postoperative pain,and significantly reduce the dosage of opioid narcotic drugs,thus alleviating adverse drug reactions,which is worthy of clinical application.
Fracture surgery in the elderlyLumbar plexus blockGeneral anesthesiaDosage of anesthetic drugsHemodynamicsPostoperative painAdverse reactions
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