Clinical Application Of Ultrasound Combined With Nerve Stimulator To Locate The Lumbar Plexus Sciatic Nerve Block In The Elderly Patients With Femoral Head Replacement

Objective:Compare the anesthesia effect of ultrasound combined with neurostimulatorr,simple ultrasound and pure neurostimulator three different methods positioning lumbar plexus and sciatic nerve block on elderly patients undergoing femoral head replacement.Methods:39 cases of elderly patients undergoing elective unilateral artificial femoral head replacement with age of 68~85 and ASA grade II ~ III,were randomly divided into three groups: the group of ultrasound combined with neurostimulator to locate lumbar plexus-sciatic nerve block(US group);the group of ultrasound-guided localization of lumbar plexus-sciatic nerve block(U group);the group of neurostimulator to locate lumbar plexus-sciatic nerve block(S group).Record the SBP,DBP and HR of before block(T0)and 10min(T1),30min(T2),60min(T3)after block in each group;Record the block completion time,the onset time and the duration time in each group;Record the incidence of adverse reactions in each group.Results:There was no significant difference in the changes of SBP,DBP and HR before block(T0),10min(T1),30min(T2),60min(T3),and 60min(T4)after block in the three groups(P>0.05);The time of nerve block completion in US group and U group was significantly shorter than that in S group(P>0.05);The onset time of sensory and motorblock in US group and S group was shorter than that in U group,and the duration of sensory and motor block was longer than that of the U group(P<0.05);The incidence of adverse reactions in U group and S group was higher than that in US group,but the difference was not statistically significant(P>0.05).Conclusion:The localization method of ultrasound combined with neurostimulator positioning lumbar plexus-sciatic nerve block on elderly patients undergoing femoral head replacement has better anesthetic effect thanneurostimulator or ultrasound-guided location anesthesia,and the incidence of adverse reactions is low,so it can be widely applied in clinical practice.