Effect of Ultrasound-guided Lumbosacral Plexus Block Combined with Superior Gluteal Nerve Block on Analgesia and Postoperative Recovery in Elderly Patients Undergoing Hip Replacement

HUANG Feibin; WU Jiling

doi:10.14033/j.cnki.cfmr.2024.33.016

Abstract：Objective:To investigate the effect of ultrasound-guided lumbosacral plexus block combined with superior gluteal nerve block on analgesia and postoperative recovery in elderly patients undergoing total hip arthroplasty(THA).Method:A total of 80 elderly patients who underwent THA in Zhangzhou Hospital hospital from April 2023 to April 2024 were selected as the study objects and divided into control group and observation group according to the random number table method,with 40 cases in each group.Both groups were given shallow general anesthesia with laryngeal mask ventilation,and the control group was given ultrasound-guided lumbosacral plexus block,the observation group was given ultrasound-guided lumbosacral plexus block and gluteal epithelial nerve block.The heart rate(HR),systolic blood pressure(SBP)and diastolic blood pressure(DBP)were compared between the two groups at the time of entering the room(T0),skin incision(T1),30 min after skin incision(T2),skin suture(T3)and before laryngeal mask extraction(T4).The pain[visual analogue pain score(VAS)]was compared between the two groups before and after operation 2 h,4 h,12 h,24 h and 48 h after operation.The postoperative recovery[postanesthesia care unit(PACU)stagnation time,intravenous analgesia(PCIA)use times,postoperative first feeding time and postoperative first ambulation time]and adverse reactions 48 h after operation were compared between the two groups.Result:HR,SBP and DBP at T1,T2,T3 and T4 in the observation group were lower than those in the control group,the difference was statistically significant(P＜0.05).The VAS scores of the observation group were lower than those of the control group 2 h,4 h,12 h and 24 h after operation(P＜0.05).There was no difference in VAS scores between the two groups 48 h after operation(P＞0.05).The number of PCIA use in the observation group was less than that in the control group(P＜0.05).The time of first eating and first ambulation in the observation group after operation was shorter than that in the control group(P＜0.05).There was no significant difference in PACU stagnation time between the two groups(P＞0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion:Ultrasound-guided lumbosacral plexus block combined with gluteal epithelial nerve block in older patients with THA provides more stable heart rate and blood pressure,clear perioperative analgesic effect,and can shorten the postoperative recovery time of patients.