Volume 29, Issue 4, 2020


DOI: 10.24205/03276716.2020.889

Safety and Effectiveness of Nerve Block Anesthesia and Low Specific Gravity Anesthesia in Unilateral Lower Extremity Trauma Surgery for Elderly Patients


Abstract
Objective: To compare the safety and effectiveness of nerve block anesthesia and low specific gravity anesthesia in the unilateral lower extremity trauma surgery for elderly patients. Methods: A total of 60 elderly patients undergoing unilateral lower extremity trauma surgery in our hospital from January 2018 to December 2019 were selected and divided into observation group (n=30) and control group (n=30) using a random number table. Control group received low specific gravity ropivacaine lumbar anesthesia, while observation group received combined lumbar plexus and sciatic nerve block. Then the anesthetic effect, onset time and duration of block, vital signs, incidence rate of intraoperative adverse reactions, recovery time of postoperative urination and lower extremity movement, and postoperative pain score were compared. Results: The excellent-good rate of anesthesia was 93.33% in observation group and 96.67% in control group, showing no statistically significant difference (P>0.05). There were no statistically significant differences in the onset time and duration of block between the two groups (P>0.05). After anesthetic injection, the systolic blood pressure, diastolic blood pressure and heart rate declined in the two groups compared with those before injection (P<0.05), while they were higher in observation group than those in control group (P<0.05). The incidence rates of chills, nausea and vomiting, and headache during operation had no statistically significant differences between the two groups (P>0.05), while the incidence rates of hypotension and bradycardia during operation were lower in observation group than those in control group (P<0.05). The recovery time of postoperative urination and lower extremity movement was shorter in observation group than that in control group (P<0.05). No statistically significant difference was observed in the pain score between the two groups at 12-48 h after operation (P>0.05). Conclusion: Both low specific gravity lumbar anesthesia and combined lumbar plexus and sciatic nerve block have a good anesthetic effect in the unilateral lower extremity trauma surgery for elderly patients. However, combined lumbar plexus and sciatic nerve block has higher anesthetic safety than low specific gravity lumbar anesthesia, which can reduce the incidence of intraoperative hypotension and bradycardia, and accelerate the recovery of postoperative urination and lower extremity movement.

Keywords
elderly; lower extremity trauma surgery; anesthesia; low specific gravity; nerve block

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