Application of Ultrasound-guided Lumbar Plexus Sciatic Nerve Block Anesthesia in Elderly Patients with Tibial Plateau Fractures

ZHANG Meng

doi:10.14033/j.cnki.cfmr.2025.01.010

Abstract：Objective:To analyze the application of ultrasound-guided lumbar plexus sciatic nerve block anesthesia in elderly patients with tibial plateau fractures. Method:A total of 80 elderly patients with tibial plateau fracture diagnosed and treated in Dingtao District People's Hospital,Heze City from July 2021 to July 2023 were selected as the study objects,and they were divided into control group 40 cases and observation group 40 cases by random number table method. The control group was given general anesthesia,and the observation group was given ultrasound-guided lumbar plexus sciatic nerve block anesthesia. Perioperative arterial partial oxygen pressure (PaO2),diastolic blood pressure (DBP),systolic blood pressure (SBP),heart rate (HR),stress response[cortisol (Cor),norepinephrine (NE),epinephrine (E)],cognitive function and postoperative adverse reactions were compared between the two groups. Result:There were no significant differences in PaO2,DBP,SBP and HR between the two groups before anesthesia (P>0.05). PaO2,DBP,SBP and HR in the observation group were higher than those in the control group at 15 min after anesthesia,45 min after anesthesia and immediately after surgery,and the differences were statistically significant (P<0.05). There was no significant difference in stress response index between the two groups immediately after surgery (P>0.05). Cor,NE and E at 2 h after surgery of the two groups were lower than those immediately after surgery,but the Cor,NE and E of the observation group were lower than those of the control group at 2 h after surgery,and the differences were statistically significant (P<0.05). The cognitive function score of the observation group was better than that of the control group at 1 d after surgery,and the differences were statistically significant (P<0.05). The incidence of postoperative adverse reactions in the observation group was significantly lower than that in the control group,the difference was statistically significant (P<0.05). Conclusion:Compared with general anesthesia,ultrasound-guided lumbar plexus sciatic nerve block anesthesia can not only provide more stable surgical conditions for elderly patients with tibial plateau fractures,but also reduce physiological stress reactions. At the same time,it has a smaller impact on cognitive function in elderly patients and can reduce the risk of postoperative adverse reactions.