Comparison of lumbar plexus-sciatic nerve block and spinal anesthesia on elderly patients with knee joint sur-gery during the perioperative period / 局解手术学杂志

Objective To compare and analyze the clinical application of lumbar plexus combined with sciatic nerve block and spinal anesthesia for elderly patients with knee joint surgery.Methods A total of 77 elderly patients with ASAⅠ ~Ⅲ undergoing single knee re-placement surgery were randomly divided into combined group which recieved lumbar plexus combined with sciatic nerve block and spinal an-esthesia group.The baseline values,blood pressure and heart rate at multiple time points,the block area and duration,the volume of intraoper-ative fluid,and other indexes of adverse reaction were observed.Results The MAP,SBP and DBP in the spinal anesthesia group after the op-eration have changed significantly at the time of T1,T2 and T3.The operating of anesthesia in the combined group was shorter than that of spi-nal anesthesia group.The rate of adverse reactions in combined group was significantly lower than that inspinal anesthesia group.Conclusion The spinal anesthesia can be satisfied for operation requirements,but it will cause the unstable circulation and varied adverse reactions.Lum-bar plexus combined with sciatic nerve block is safe and effective with less adverse reactions,less disturbance of hemodynamics,which is much better for the old or the patients with coagulation abnormalities combined heart and lung disease.

Clinical effect of nerve stimulator combined with low back plexus sciatic nerve block for the arthroscopy anesthesia / 实用医学杂志

Objective To study the clinical effect of nerve stimulator combined with low back piexus sciatic nerve block for the arthroscopic surgery anesthesia. Methods 86 patients who required the arthroscopic surgery from March 2010 to March 2013 in our hospital were randomly divided into observation group (43 cases) and control group (43 cases). The observation group accepted nerve stimulator combined with low back plexus sciatic nerve block under the arthroscopic surgery;the control group adopted waist hard joint anesthesia during the arthroscopic surgery. Data of hemodynamics, effects of anesthesia, anesthesias maintaining time, rehydration fluids and adverse effect in both groups were recorded and compared. Results The time for preparation and control of anesthesia operation (Tr), time for feeling completely block (T1), time for recovery (T2), time for completely blocking (T3), time for movement recovery (T4) in observation group were significantly shorter than that of the observation group (P<0.05); the first time of urination (Tu) after operation was significantly longer in control group than that in the observation group (P < 0.05); MAP in the control group were lower than that in the observation group 20 minutes after anesthesia (T20,P < 0.05); complications in the control group were more frequent than that in the observation group. Conclusion The clinical effect of nerve stimulator combined with low back plexus sciatic nerve block for the arthroscopic surgery anesthesia is more obvious , especially for patients with relatively long operating time.