Abstract:

BACKGROUND: The anesthesia for elderly hip replacement mainly includes general anesthesia, lumbar anesthesia, and epidural anesthesia. Lumbar anesthesia alone could induce limitations in anesthesia plane and duration.
OBJECTIVE: To observe the effect of lumbar plexus blocking combined with isobaric bupivacaine anesthesia versus epidural anesthesia in total hip replacement.
METHODS: A total of 46 elder patients undergoing hip replacement were divided into two groups, and were anesthetized using lumbar plexus blocking combined isobaric bupivacaine or epidural anesthesia combined low-dose bupivacaine. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and pulse oxygen saturation (spo2) were compared before, 5, 10, 15, 20, 30 minutes after anesthesia. Algesthesia block level, temperature sensation, Bromage score were observed. Adverse reactions, effective analgesia duration and blocking duration were recorded.
RESULTS AND CONCLUSION: There was no significant difference in SBP, DBP, HR, in lumbar plexus block combined isobaric bupivacaine anesthesia before and after anesthesia (P > 0.05). There was significant difference in block level, temperature sensation, Bromage score between affected limbs and normal limbs (P < 0.01). Lumbar plexus block combined isobaric bupivacaine anesthesia exhibited longer effective analgesia duration and blocking duration compared with epidural anesthesia combined with low-dose bupivacaine, demonstrating lumbar plexus block combined isobaric bupivacaine anesthesia is safe and controllable in total hip replacement, which reduces drug dose, does not change anesthesia body position, with stable circulation.