Abstract:

OBJECTIVE: To explore isobaric spinal anesthesia in combination with lumbar plexus anesthesia in application of elderly hip joint surgery.
METHODS: With lumbar anesthesia, hip replacement as Chinese key words, articles published between January 2000 and March 2010 were searched. Articles related with lumbar anesthesia, hip replacement were included. Repetitive studies were excluded. Finally, 11 articles were discussed, and 50 patients selectively undergoing hip replacement were selected as clinical validation. Using isobaric spinal anesthesia in combination with lumbar plexus anesthesia, the patients were maintained in lateral position. Hemodynamics and heart rate changes before, and 5, 15, 30 minutes after anesthesia were observed. Bilateral algesia blocking plane, temperature sense and touch sensation, Bromage motor blocking score, adverse effects, effective analgesia time and effective blocking time of affected limbs were investigated.
RESULTS: Currently used anesthesia methods for the elderly hip replacement include ropivacaine lateral combined spinal epidural anesthesia, levobupivacaine in combination with sufentanil combined spinal epidural anesthesia, continuous epidural anesthesia in combination with low-dose bupivacaine lumbar anesthesia. Studies have shown that combined anesthesia displays better than medication alone. Clinical results show that hemodynamics and heart rate remained unchanged following isobaric spinal anesthesia in combination with lumbar plexus anesthesia. Algesia blocking plane, temperature sense and touch sensation, Bromage motor blocking score of lesioned side displayed significant differences compared with normal side (P < 0.01). In addition, 1 case developed vomiting and 6 hypotension. The effective analgesia time and effective blocking time of affected limbs were (5.5±2.2) hours and (2.5±0.5) hours were investigated.
CONCLUSION: Isobaric spinal anesthesia in combination with lumbar plexus anesthesia is safe and reliable in elderly hip replacement with little physiological interference.