Zhen Fang, Mengsi Li, Ting Jiang, Yan Zhao, Lu Chang
{"title":"超声引导腰丛前路阻滞联合快速骶丛阻滞喉罩全麻在老年全髋关节置换术中的应用。","authors":"Zhen Fang, Mengsi Li, Ting Jiang, Yan Zhao, Lu Chang","doi":"10.62347/PADU2071","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the effects of ultrasound-guided anterior lumbar plexus block combined with rapid sacral plexus block and laryngeal mask general anesthesia in elderly patients undergoing total hip arthroplasty (THA).</p><p><strong>Methods: </strong>This retrospective study involved 84 elderly patients, divided into two groups based on anesthesia method: control group (n=40) and observation group (n=44). Hemodynamics, including mean arterial pressure (MAP), heart rate (HR), and oxygen saturation (SpO<sub>2</sub>) were compared between the two groups before anesthesia (T0), after induction of anesthesia (T1), immediately after skin incision (T2), and immediately after the end of surgery (T3). Preoperative and postoperative (1 day after surgery) levels of cortisol, blood glucose, norepinephrine, and adrenaline were compared between the two groups. Postoperative recovery time, laryngeal mask removal time, observer's assessment of alertness/sedation (OAA/S) score, and incidence of postoperative complications were also recorded.</p><p><strong>Results: </strong>From T1-T3, the MAP, HR, and SpO<sub>2</sub> were significantly higher in the observation group than those of the control group (all <i>P</i><0.05). The anesthetic effect in the observation group was better than that of the control group (<i>P</i><0.05). At 1d after surgery, levels of cortisol, blood glucose, norepinephrine, and adrenaline increased in both groups, but they were lower in the observation groups than in the control group. The OAA/S score was lower in the observation group, and both postoperative recovery time and laryngeal mask removal time were shorter than those of the control group (all <i>P</i><0.05). Patients were further categorized into an orthostatic intolerance (OI) group (n=38) and a non-OI group (n=46) after THA. Factors influencing OI in elderly patients included BMI, decreased hemoglobin levels, and MFES score.</p><p><strong>Conclusion: </strong>Ultrasound-guided anterior lumbar plexus block combined with rapid sacral plexus block and laryngeal mask general anesthesia provides a superior anesthesia effect and reduces postoperative complications in elderly patients undergoing THA.</p>","PeriodicalId":7731,"journal":{"name":"American journal of translational research","volume":"17 4","pages":"3189-3197"},"PeriodicalIF":1.6000,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082533/pdf/","citationCount":"0","resultStr":"{\"title\":\"Use of ultrasound-guided anterior lumbar plexus block combined with rapid sacral plexus block and laryngeal mask general anesthesia in elderly patients undergoing total hip arthroplasty.\",\"authors\":\"Zhen Fang, Mengsi Li, Ting Jiang, Yan Zhao, Lu Chang\",\"doi\":\"10.62347/PADU2071\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To evaluate the effects of ultrasound-guided anterior lumbar plexus block combined with rapid sacral plexus block and laryngeal mask general anesthesia in elderly patients undergoing total hip arthroplasty (THA).</p><p><strong>Methods: </strong>This retrospective study involved 84 elderly patients, divided into two groups based on anesthesia method: control group (n=40) and observation group (n=44). Hemodynamics, including mean arterial pressure (MAP), heart rate (HR), and oxygen saturation (SpO<sub>2</sub>) were compared between the two groups before anesthesia (T0), after induction of anesthesia (T1), immediately after skin incision (T2), and immediately after the end of surgery (T3). Preoperative and postoperative (1 day after surgery) levels of cortisol, blood glucose, norepinephrine, and adrenaline were compared between the two groups. Postoperative recovery time, laryngeal mask removal time, observer's assessment of alertness/sedation (OAA/S) score, and incidence of postoperative complications were also recorded.</p><p><strong>Results: </strong>From T1-T3, the MAP, HR, and SpO<sub>2</sub> were significantly higher in the observation group than those of the control group (all <i>P</i><0.05). The anesthetic effect in the observation group was better than that of the control group (<i>P</i><0.05). At 1d after surgery, levels of cortisol, blood glucose, norepinephrine, and adrenaline increased in both groups, but they were lower in the observation groups than in the control group. The OAA/S score was lower in the observation group, and both postoperative recovery time and laryngeal mask removal time were shorter than those of the control group (all <i>P</i><0.05). Patients were further categorized into an orthostatic intolerance (OI) group (n=38) and a non-OI group (n=46) after THA. Factors influencing OI in elderly patients included BMI, decreased hemoglobin levels, and MFES score.</p><p><strong>Conclusion: </strong>Ultrasound-guided anterior lumbar plexus block combined with rapid sacral plexus block and laryngeal mask general anesthesia provides a superior anesthesia effect and reduces postoperative complications in elderly patients undergoing THA.</p>\",\"PeriodicalId\":7731,\"journal\":{\"name\":\"American journal of translational research\",\"volume\":\"17 4\",\"pages\":\"3189-3197\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-04-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082533/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American journal of translational research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.62347/PADU2071\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, RESEARCH & EXPERIMENTAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of translational research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.62347/PADU2071","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
Use of ultrasound-guided anterior lumbar plexus block combined with rapid sacral plexus block and laryngeal mask general anesthesia in elderly patients undergoing total hip arthroplasty.
Objectives: To evaluate the effects of ultrasound-guided anterior lumbar plexus block combined with rapid sacral plexus block and laryngeal mask general anesthesia in elderly patients undergoing total hip arthroplasty (THA).
Methods: This retrospective study involved 84 elderly patients, divided into two groups based on anesthesia method: control group (n=40) and observation group (n=44). Hemodynamics, including mean arterial pressure (MAP), heart rate (HR), and oxygen saturation (SpO2) were compared between the two groups before anesthesia (T0), after induction of anesthesia (T1), immediately after skin incision (T2), and immediately after the end of surgery (T3). Preoperative and postoperative (1 day after surgery) levels of cortisol, blood glucose, norepinephrine, and adrenaline were compared between the two groups. Postoperative recovery time, laryngeal mask removal time, observer's assessment of alertness/sedation (OAA/S) score, and incidence of postoperative complications were also recorded.
Results: From T1-T3, the MAP, HR, and SpO2 were significantly higher in the observation group than those of the control group (all P<0.05). The anesthetic effect in the observation group was better than that of the control group (P<0.05). At 1d after surgery, levels of cortisol, blood glucose, norepinephrine, and adrenaline increased in both groups, but they were lower in the observation groups than in the control group. The OAA/S score was lower in the observation group, and both postoperative recovery time and laryngeal mask removal time were shorter than those of the control group (all P<0.05). Patients were further categorized into an orthostatic intolerance (OI) group (n=38) and a non-OI group (n=46) after THA. Factors influencing OI in elderly patients included BMI, decreased hemoglobin levels, and MFES score.
Conclusion: Ultrasound-guided anterior lumbar plexus block combined with rapid sacral plexus block and laryngeal mask general anesthesia provides a superior anesthesia effect and reduces postoperative complications in elderly patients undergoing THA.
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