Effects of general anesthesia combined with ultrasound-guided lumbosacral plexus block on hemodynamics and postoperative rehabilitation in geriatric patients with total hip arthroplasty.

Abstract

Background: The incidence of fractures increases with age, and it is estimated that the incidence in women is higher than that in men.

Objective: To investigate the influence of general anesthesia & ultrasound-guided lumbosacral plexus block in elderly patients with total hip arthroplasty (THA).

Methods: Eighty-one geriatric sufferers who were sent to our hospital from July 2019 to January 2021 and underwent THA surgery in the Department of Orthopedics were divided into Grades I to III according to American Society of Anesthesiologists (ASA). Forty-one patients were ascribed to a combination group (using general anesthesia combined with guided lumbosacral plexus block), and forty to a general anesthesia group (with general anesthesia) by a random number table to compare the differences in mean arterial pressure (MAP), heart rate (HR), pulse oxygen saturation (SpO2), intraoperative general anesthesia dosage, incidence of postoperative delirium (POD), serum inflammation and oxidative stress indexes between them.

Results: Prior to anesthesia induction, MAP, HR, and SpO2 between them had significant differences (P>0.05); at skin-incision-time and implantation of the prosthesis, the MAP value of the experimental group was higher than that of the general anesthesia group, 30 minutes after surgery, the SpO2 was higher than the general anesthesia group, and had significant differences (P<0.05); prior to the surgery, had significant differences in measured values such as Cor, blood glucose, IL-6, CRP, MDA and SOD between the two groups (P>0.05); 2 hours after that, the values of Cor, CRP, and MDA in experimental group were lower than the general anesthesia group, and that of IL-6 and SOD were higher than those in the general anesthesia group, and had significant differences (P<0.05); the dosage of propofol, remifentanil, sufentanil in experimental group were lower than the general anesthesia group, while postoperative extubation time in experimental group was earlier than general anesthesia group, and had significant differences (P<0.05); the incidence of POD in experimental group was lower than the general anesthesia group at 1d, 2d, and 3d after surgery, and had significant differences (P<0.05); the incidence of adverse reactions of anesthesia in experimental group was lower than the general anesthesia group with 9.76 % to 27.50 %, and had significant differences (P<0.05).

Conclusion: General anesthesia & ultrasound-guided lumbosacral plexus block in THA patients is more conducive to the patients' hemodynamic stability, reducing inflammatory stress response, the dosage of anesthetic drugs, and the incidence of POD, compared with general anesthesia alone.