Effects of ultrasound-guided lumbar-sciatic nerve block on hemodynamics and stress in elderly patients with hip fractures

ZHOU Qin; XIE Min; HUANG Jian-xin

doi:10.3969/j.issn.1674-3806.2019.01.14

Abstract：Objective To investigate the effects of ultrasound-guided lumbar-sciatic nerve block on hemodynamics and stress in elderly patients with hip fractures.MethodsA prospective study was performed on 63 elderly patients with hip fractures in the Department of Orthopedics of Sichuan Provincial People's Hospital from June 2016 to December 2017 and the patients were divided into control group (n=32) and treatment group (n=31) using a random number table.The control group underwent conventional combined spinal and epidural anesthesia.The observation group underwent ultrasound-guided anesthesia with lumbar plexus combined with sciatic nerve block.The hemodynamic related indicators[mean arterial pressure (MAP), systolic blood pressure (SBP), pulse oximetry (Sp O2) and heart rate (HR) and stress response related indicators[blood sugar (GLU), interleukin-6 (IL-6) and cortisol (COR) levels]and Postoperative Simple Mental Condition Checklist (MMSE) and Visual Analogue Scale (VAS) were compared between the two groups before and after anesthesia.Results There were no significant differences in hemodynamic parameters and stress response related indicators between the two groups before anesthesia (P＞0.05).After anesthesia, the MAP and SBP levels and stress response related indicators were significantly different between the two groups (P＜0.05).There were no significant differences in Sp O2and HR between the two groups (P＞0.05).The MMSE scores were significantly higher and the VAS scores were significantly lower in the treatment group than those in the control group 12 and 24 hours after operation (P＜0.05).Conclusion Ultrasound-guided lumbar-sciatic nerve block has certain advantages and is worthy of clinical application.