Application of B-ultrasound Guided Lumbar Plexus Block("Clover"Method)Combined with Laryngeal Mask General Anesthesia with Different Entropy Index Control Levels in Elderly Patients with THA
Objective:To explore and analyze the application effect of B-ultrasound guided lumbar plexus block("clover"method)combined with laryngeal mask general anesthesia with different entropy index control level in elderly patients with total hip arthroplasty(THA).Method:Forty-two elderly patients with THA treated in Yunfu People's Hospital from June 2021 to October 2023,according to the operation time sequence,patients with odd days of operation time were included in group L and patients with even days were included in group D.Group D was given deep anesthesia with laryngeal mask general anesthesia,and the entropy index was maintained at 40-50;group L was given shallow anesthesia with laryngeal mask general anesthesia,and the entropy index was maintained at 50-60.The visual analogue scale(VAS)scores before operation and 6,12,24,48 h after operation,mini-mental state examination(MMSE)scores before operation and 1,3,7 d after operation,postoperative recovery,vital signs at admission,immediately after skin incision,15 min,30 min after the start of surgery,and immediately after operation,and use of postoperative controlled analgesia were compared between the two groups.Result:There were no significant differences in VAS scores before operation and 6,12,24,48 h after operation between the two groups(P＞0.05),However,they were significantly lower than those before operation(P＜0.05).There were no significant differences in MMSE scores between the two groups before and 1,3 and 7 d after surgery(P＞0.05).The postoperative recovery time,extubation time and orientation recovery time of patients in group L were significantly earlier than those in group D(P＜0.05).There were no significant differences in RR,HR and MAP between the two groups when entering the room,immediately after skin incision,15 min after the start of surgery,30 min after the start of surgery,and immediately after surgery(P＞0.05).RR,HR and MAP of both groups were significantly decreased immediately after incision,15 minutes after the start of surgery,30 minutes after the start of surgery,and immediately after surgery compared those at entering the room(P＜0.05).There were no significant differences between the two groups in the first time of use of postoperative controlled analgesia,the average number of use,the amount of Sufentanil used,and the effective compression rate(P＞0.05).Conclusion:The application of B-ultrasound guided lumbar plexus block("clover"method)combined with laryngeal mask general anesthesia in elderly THA patients has significant anesthetic and postoperative analgesic effects,maintaining patients in a stable state,but the entropy index control of 50-60(shallow anesthesia)can play a significant anesthetic and analgesic effect,especially in the postoperative recovery of patients.
B-ultrasound guided lumbar plexus blockEntropy indexLaryngeal mask general anesthesiaTotal hip arthroplastyElderly
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