Comparison of Lumbar Plexus Nerve Block and General Anesthesia in the Patients Aged over 70 Years Un-dergoing Total Hip Replacement / 中国药师

ABSTRACT

Objective:To compare the clinical effects of dexmedetomidine assisted lumbar plexus nerve block and propofol-remifentanil general anesthesia in the patients aged over 70 years undergoing total hip replacement. Methods:Totally 58 patients(≥70 years old) with selective total hip replacement were divided into dexmedetomidine assisted lumbar plexus nerve block group(group A,28 cases) and propofol-remifentanil general anesthesia group (group B,30 cases) according to the time order of operation. The perioperative stability of respiratory and circulatory,postoperative recovery,anesthesia complications in 24 h after the surgery and anes-thesia satisfaction were evaluated and compared between the groups. Results:The vital signs of group A during the operation had no significant difference among each time point(P>0.05). There was statistical signification in blood pressure and heart rate before and after the anesthesia induction and the tracheal intubation in group B(P<0.05). Perioperative cardiovascular drug use in group B was significantly more than that in group A(P<0.01). Totally 20 cases in group A were directly sent back to the ward after the operation, another 8 cases was in anesthesia recovery room for 0.5~1-hour observation. Totally 12 cases with postoperative controlled breathing in group B were directly sent back to the intensive care unit,another 7 cases pulled out the endotracheal tube and were sent back to the intensive care unit and another 11 cases were observed in anesthesia recovery room for 1-2 h. The occurrence of postoperative cognitive dysfunction in group B was significantly higher than that in group A(P<0.05),while the anesthesia satisfaction was extremely lower than that in group A(P<0.01). Conclusion:For the patients aged over 70 years undergoing total hip replacement,dexmedetomidine at moderate dose assisted lumbar plexus nerve block is more ideal anesthesia.