Effect of lumbar plexus-sacral plexus block combined with dexmedetomidine on rehabilitation of elderly patients undergoing PFNA
10.3969/j.issn.1671-8348.2018.12.013
- VernacularTitle:腰丛-骶丛神经阻滞复合右美托咪定对老年PFNA手术患者康复的影响
- Author:
Junyu ZHOU
1
;
Han ZHANG
;
Weijia YUAN
;
Xia YUAN
;
Wei DAI
;
Kaihua HE
Author Information
1. 重庆医科大学附属第一医院麻醉科
- Keywords:
proximal femoral nail antirotation;
ultrasound;
nerve stimulator;
lumbosacral plexus block;
dexmedetomidine
- From:
Chongqing Medicine
2018;47(12):1616-1619,1624
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effectiveness of lumbosacral plexus block combined with the use of dexmedetomidine in elderly patients undergoing proximal femoral nail antirotation (PFNA).Methods A total of 60 patients received elective PFNA were divided into tracheal intubation combined with inhalation anesthesia group (group G) and ultrasound and nerve stimulator-guided lumbosacral plexus block following with dexmedetomidine infusion group (group N).Then we observed HR,SBP,DBP for both groups at the time entering the theater (T0),immediately after tracheal intubation or after dexmedetomidine infusion (T1),skin incision moment (T2) and 30 minutes after skin incision (T3).Visual analogue scale (VAS) scores were assessed for both groups at the time point of 2,6,12,24 and 48 hours after surgery.The number of use of patient controlled intravenous analgesia (PCIA),assessment of consciousness status 1-3 days after surgery,adverse reactions were recorded for both groups as well.The following post-surgery data were recorded:the time of first feeding,first urination and first ambulation,the length of hospitalization,the expense of hospital stay.Results HR,SBP,DBP of the group G changed more significantly at T1,T2,T3 than those of T0 (P＜0.05).The VAS scores and the number of use of PCIA of group N were lower than those of group G at all time points after operation (P＜0.05).The group N had lower CAM-CR scores and less adverse reactions of nausea and vomiting and dizziness than those of group G on days 1 to 3 after surgery (P＜0.01).Compare to group G,the group N were early in terms of post-operation first feeding,first urination and first ambulation (P＜0.01).The length of hospitalization was shorter and the cost of the hospital stay was lower in the group N than the group G (P＜0.01).Conclusion Ultrasound and nerve stimulator-guided lumbosacral plexus block combined with low dose of dexmedetomidine could meet the needs of elderly patients undergoing PFNA.
