The effect of etomidate combined with lumbar plexus sciatic nerve block in surgery for upper femoral fractures in elderly patients
10.3760/cma.j.cn431274-20230816-00124
- VernacularTitle:依托咪酯复合腰丛-坐骨神经联合阻滞在老年患者股骨上段骨折手术中的效果
- Author:
Suli WANG
1
;
Juan WANG
;
Ying LIU
Author Information
1. 淮北矿工总医院麻醉科，淮北 235000
- Keywords:
Femoral fractures;
Etomidate;
Nerve block;
Lumbar plexus;
Sciatic nerve
- From:
Journal of Chinese Physician
2024;26(5):697-701
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of etomidate combined with lumbar plexus sciatic nerve block in the surgery of upper femoral fractures in elderly patients.Methods:A total of 64 elderly patients who underwent surgery for upper femoral fractures at the Huaibei Miner General Hospital from April 2021 to April 2023 were selected as the study subjects. They were randomly divided into group A and group B using a random number table method, with 32 patients in each group. Group A received propofol induced anesthesia and continuous inhalation of sevoflurane to maintain anesthesia, while group B received etomidate induced anesthesia and continuous infusion to maintain anesthesia. Both groups underwent lumbar plexus sciatic nerve block before general anesthesia induction. Two groups were compared in terms of surgical time, postoperative recovery time, intraoperative use of epinephrine, perioperative hemodynamic indicators (heart rate, diastolic blood pressure, systolic blood pressure), sensory nerve block, motor nerve block, postoperative cognitive function and pain level, adverse reactions, and complications.Results:There was no statistically significant difference in surgical time between the two groups of patients ( P>0.05); The postoperative recovery time of group A patients was shorter than that of group B, and the proportion of epinephrine use was higher than that of group B (all P<0.05). There was no statistically significant difference in heart rate, diastolic blood pressure, and systolic blood pressure between the two groups of patients before anesthesia ( P>0.05); There was no statistically significant difference in heart rate between the two groups of patients at 15 minutes after anesthesia (T 2) and 60 minutes after surgery (T 3) (all P>0.05); The diastolic and systolic blood pressure of both groups of patients at T 2 and T 3 were lower than before anesthesia (T 1), and group A was lower than group B (all P<0.05). There was no statistically significant difference in the onset and maintenance time of sensory nerve block and motor nerve block between the two groups of patients (all P>0.05). The postoperative Mini Mental State Examination (MMSE) scores and Visual Analog Scale (VAS) scores of both groups of patients were lower than those before surgery ( P<0.05); And the postoperative MMSE score in group A was lower than that in group B ( P<0.05). The incidence of postoperative adverse reactions and complications in group A was higher than that in group B ( P<0.05). Conclusions:The implementation of etomidate combined with lumbar plexus sciatic nerve block anesthesia in the surgery of upper femoral fractures in elderly patients can effectively stabilize the perioperative hemodynamics of patients, reduce postoperative damage to cognitive function, and achieve good intraoperative anesthesia effect and safety.
