Clinical application of C-arm guided lumbar plexus and sciatic nerve blockade on elderly patients with lower limb surgery

doi:10.3969/j.issn.1674-3806.2015.12.13

Abstract：Objective To compare the effects of C-arm guided lumbar plexus and sciatic nerve blockade and epidural anesthesia on elderly patients with lower limb surgery.Methods Sixty elderly cases(ASAⅠ ~Ⅲ) were di-vided into the lumbar plexus and sciatic nerve blockade group(group A, n =30) and the epidural anesthesia group (group B, n =30).Patients in group A received C-arm guided lumbar plexus and sciatic nerve blockade, with 30 ml and 20 ml of 0.375% ropivacaine administrated to the lumbar plexus and sciatic nerve respectively; Patients in group B received epidural anesthesia and were administrated with 10 ~15 ml of 0.375% ropivacaine.Hemodynamic chan-ges, the effects of blockade and adverse reactions were observed in both groups.Results The systolic pressure, dias-tolic pressure and heart rate in group A were more stable than those in group B.The number of patients using ephed-rine in group A was much smaller than that in group B(P <0.01).The sensory block onset time of group A was lon-ger than that of group B(P <0.01), while the hold time of sensory and motor nerve block onset time of group A was significantly longer than that of group B(P <0.01).Adverse reactions such as nausea, vomit and retention of urine in group B during the preoperative period were much more severe than those in group A(P <0.01).Conclusion The application of lumbar plexus and sciatic nerve blockade in unilateral lower limb surgery can not only meet the sur-gical requirements, but also have a small impact on hemodynamics, less complications, longer duration of pain relief and less adverse reactions.Therefore, it is especially suitable for frail elderly patients.