DING Baofeng, LIU Xuejia, XING Xiaoming, YANG Chunxiao, JING Yusheng. Lumbar plexus-sciatic nerve block anesthesia versus spinal-epidural combined anesthesia respectively combined with dexmedetomidine for patients with femoral neck fracture[J]. Journal of Clinical Medicine in Practice, 2022, 26(17): 92-95. DOI: 10.7619/jcmp.20221724
Citation: DING Baofeng, LIU Xuejia, XING Xiaoming, YANG Chunxiao, JING Yusheng. Lumbar plexus-sciatic nerve block anesthesia versus spinal-epidural combined anesthesia respectively combined with dexmedetomidine for patients with femoral neck fracture[J]. Journal of Clinical Medicine in Practice, 2022, 26(17): 92-95. DOI: 10.7619/jcmp.20221724

Lumbar plexus-sciatic nerve block anesthesia versus spinal-epidural combined anesthesia respectively combined with dexmedetomidine for patients with femoral neck fracture

More Information
  • Received Date: June 01, 2022
  • Available Online: September 20, 2022
  • Objective 

    To compare the anesthetic effect of lumbar plexus-sciatic nerve block anesthesia and combined spinal-epidural anesthesia respectively combined with dexmedetomidine for patients with femoral neck fracture.

    Methods 

    A total of 80 elderly patients with femoral neck fracture were randomly divided into control group and study group, with 40 cases in each group. The control group was treated with lumbar plexus-sciatic nerve block anesthesia and dexmedetomidine, while the study group was treated with combined spinal-epidural anesthesia and dexmedetomidine. The anesthesia effect, anesthesia indexes, changes of vital signs before and after anesthesia, pain scores at different time points after operation, and adverse reactions were compared between the two groups.

    Results 

    The excellent and good rate of anesthesia in the study group was 95.00%, which was significantly higher than 72.50% in the control group (P < 0.05). The onset time of anesthesia, duration of motor nerve block and duration of sensory block in the study group were significantly shorter than those in the control group, while the duration of analgesia was significantly longer than that in the control group (P < 0.05). There were no significant differences in mean arterial pressure (MAP), heart rate (HR) and blood oxygen saturation (SpO2) before anesthesia between the two groups (P > 0.05); the MAP and HR after operation in the control group were significantly lower than those before operation in the same group and in the same period in the study group (P < 0.05). The pain scores of the study group were significantly lower than those of the control group at 2, 12 and 24 hours after operation (P < 0.05). The incidence of adverse reactions in the study group was 7.50%, which was significantly lower than 25.00% in the control group (P < 0.05).

    Conclusion 

    Combined spinal-epidural anesthesia and dexmedetomidine can better maintain the stability of physical function of elderly patients, which is more favorable for the prognosis of patients.

  • [1]
    张雪东. 喉罩通气全麻与腰硬联合麻醉用于老年股骨颈骨折患者内固定术治疗中的效果对比[J]. 中国现代药物应用, 2021, 15(17): 7-10. https://www.cnki.com.cn/Article/CJFDTOTAL-ZWYY202117003.htm
    [2]
    WEI P R, XU Y, GU Y, et al. Conservative vs surgical treatment of impacted femoral neck fracture in patients 75 years and older[J]. J Am Geriatr Soc, 2020, 68(10): 2214-2221. doi: 10.1111/jgs.16535
    [3]
    李智海, 张忠源, 叶桂云. 腰硬联合麻醉及全身麻醉在老年患者股骨颈骨折手术的麻醉浅析[J]. 中外医疗, 2017, 36(16): 93-95, 98. https://www.cnki.com.cn/Article/CJFDTOTAL-HZZZ201716033.htm
    [4]
    赵金明. 盐酸右美托咪定在膝关节镜手术腰硬联合麻醉中的应用效果观察[J]. 中国实用医药, 2018, 13(6): 125-126. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSSA201806078.htm
    [5]
    QIN B Q, CUI L X, REN Y, et al. Retrospective cohort trial protocol of screw fixation compared with hemiarthroplasty for displaced femoral neck fractures in elderly patients[J]. Medicine, 2020, 99(39): e22397. doi: 10.1097/MD.0000000000022397
    [6]
    岳文燕. 盐酸右美托咪定在膝关节镜手术腰硬联合麻醉中的应用效果和安全性分析[J]. 中国医药指南, 2018, 16(19): 173-174. https://www.cnki.com.cn/Article/CJFDTOTAL-YYXK201819132.htm
    [7]
    曾凡英. 盐酸右美托咪定联合腰-硬联合麻醉对髋部骨折患者术后谵妄的影响[J]. 临床合理用药杂志, 2021, 14(15): 110-112. https://www.cnki.com.cn/Article/CJFDTOTAL-PLHY202115039.htm
    [8]
    王涛. 老年股骨颈骨折手术患者的临床麻醉[J]. 东方药膳2021, 1(11): 113-113. https://www.cnki.com.cn/Article/CJFDTOTAL-WSBZ201531132.htm
    [9]
    田旭. 右美托咪定对老年股骨颈骨折患者麻醉安全性的影响[J]. 中国伤残医学, 2021, 29(10): 92-94.
    [10]
    欧永贵, 刁展贵, 欧荣星. 腰丛-坐骨神经阻滞麻醉与腰硬联合麻醉用于下肢手术的血流动力学及临床效果观察[J]. 中国伤残医学, 2020, 28(12): 12-14. https://www.cnki.com.cn/Article/CJFDTOTAL-SXYY201605025.htm
    [11]
    赵振海, 陈治军, 秦朝生, 等. 超声引导下腰丛-坐骨神经阻滞与腰硬联合麻醉在单侧全髋关节置换术中的效果比较[J]. 影像研究与医学应用, 2018, 2(13): 30-32. https://www.cnki.com.cn/Article/CJFDTOTAL-YXYY201813017.htm
    [12]
    FU G T, LI M Y, XUE Y L, et al. Rapid preoperative predicting tools for 1-year mortality and walking ability of Asian elderly femoral neck fracture patients who planned for hip arthroplasty[J]. J Orthop Surg Res, 2021, 16(1): 455.
    [13]
    CHENG W J, WANG M J, LIU P, et al. Protective effects of dexmedetomidine and oxycodone in patients undergoing limb ischemia-reperfusion[J]. Med Sci Monit, 2019, 25: 9073-9084.
    [14]
    郭武龙. 右美托咪定复合腰-硬联合麻醉对老年人工全髋关节置换术患者的影响研究[J]. 中国药物与临床, 2020, 20(21): 3614-3616. https://www.cnki.com.cn/Article/CJFDTOTAL-YWLC202021035.htm
    [15]
    龚航. 腰硬联合麻醉和全身麻醉在老年患者股骨颈骨折手术过程中的应用效果比较[J]. 中外医疗, 2020, 39(9): 74-75, 87.
    [16]
    许玉军, 陆振华. 腰硬联合麻醉、全身麻醉在老年患者股骨颈骨折手术中的麻醉效果[J]. 临床医学研究与实践, 2019, 4(21): 32-34. https://www.cnki.com.cn/Article/CJFDTOTAL-YLYS201921014.htm
    [17]
    彭学勇, 刘仁齐, 朱瑶, 等. 右美托咪定对老年腰硬联合麻醉患者镇静、呼吸及血流动力学的影响[J]. 西部医学, 2019, 31(7): 1097-1101. https://www.cnki.com.cn/Article/CJFDTOTAL-XIBU201907028.htm
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