Application of ultrasound-guided combined lumbar plexus and sacral sciatic nerve block in internal fixation of femoral neck fracture
ZUO Dong
ZHOU Min
Abstract：Objective To investigate the effect of ultrasound-guided combined lumbar plexus and sacral sciatic nerve block in internal fixation of femoral neck fracture.Methods Eighty elderly patients with femoral neck fracture treated in No.457 Air Force Hospital of PLA from Jan.2015 to Mar.2016 were selected for the study,and were randomly divided into the control group and the observation group.The control group consisted of 40 patients,including 18 males and 22 females aged 75-92 years (mean,85.67 years).The posterior lumbar plexus combined with sciatic nerve block anesthesia was guided by the traditional nerve stimulator.There were 40 cases in the observation group,including 19 males and 21 females aged 76-93 years,with an average age of 85.72 years.The observation group was treated with ultrasound-guided plexus combined with sacral sciatic nerve block.The differences of cardiopulmonary function,cognitive function (directional force,instantaneous memory and attention calculation ability) and postoperative pain between the two groups were observed.Results The mean arterial pressure (MAP) before anesthesia puncture in the control group and the observation group was (92.32±10.42) mmHg and (92.35±11.27) mmHg,without statistical difference between the two groups.The heart rate (HR) before anesthesia puncture in the control group and the observation group was (67.53±6.87) times/min and (67.45±1.25) times/min,without statistical difference between the two groups.The MAP at 10 min after anesthesia,at operation and after operation in the observation group was (91.03±7.85) mmHg,(88.67±8.93) mmHg,(85.45±8.12) mmHg,respectively,which were significantly higher than those of the control group ((86.75±8.32) mmHg,(84.01±7.65) mmHg,(80.14±7.54)mmHg,respectively),and the differences were statistically significant (P<0.05).The HR at 10 min after anesthesia,at operation and after operation in the observation group was (67.92±1.89) times/min,(68.12±1.34)times/min,(66.97±1.26)times/min,respectively,which were significantly higher than those of the control group ((63.25±1.69)times/min,(60.42±1.25)times/min,(60.48±1.89)times/min),and the differences were statistically significant (P<0.05).There was no remarkable difference in the cognitive function index such as directional force,instantaneous memory and attention between the two groups,which were lower than those before operation.The visual analogue score (VAS) of the observation group at 2 h after operation was (3.11±0.75) points,which was lower than that of the control group((4.02±1.11) points,P>0.05).Conclusion Ultrasound-guided combined lumbar plexus and sacral sciatic nerve block in treating femoral neck fracture has no remarkable effect on the heart and lung function,has good anesthetic effect,and can significantly reduce postoperative pain.
Keywords：femoral neck fractureinternal fixationultrasoundlumbar plexussciatic nerve blockelderly
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 503-507 )