ObjectiveTo investigate the differences of anesthesia effects between lumbar plexus-sciatic nerve block and combined spinal-epidural anesthesia in elderly patients treated with femoral head replacement.

MethodsA total of 78 patients treated with femoral head replacement were divided into two groups according to different anesthesia methods.Thirty-nine patients treated with combined lumbar-epidural anesthesia and 39 cases treated with lumbar plexus-sciatic nerve block were divided into the spinal-epidural group and nerve block group, respectively.The hemodynamic changes and VAS score before and after anesthesia, intraoperative vasoactive drugs and analgesic drugs were observed in two groups.

ResultsThere was no statistical significance in blood pressure and heart rate between two groups before anesthesia (P>0.05).After anesthesia, the difference of the heart rate and diastolic blood pressure between two groups were not statistically significant (P>0.05), and the level of systolic pressure in nerve block group was higher than that in spinal-epidural group (P < 0.01).After anesthesia, the blood pressure levels in two groups decreased compared with before anesthesia (P < 0.05 to P < 0.01), the heart rate in spinal-epidural group decreased compared with before anesthesia (P < 0.05), and the difference of the heart rate in nerve block group was not statistically significant between before and after anesthesia (P>0.05).After anesthesia, the VAS score in spinal-epidural group was significantly lower than that in nerve block group (P < 0.01), and the VAS scores in two groups were significantly lower than those before anesthesia (P < 0.01) The amount of intraoperative ephedrine and fluid supplementation in spinal-epidural group were significantly higher than those in nerve block group (P < 0.01), and the amount of intraoperative analgesic drugs in spinal-epidural group was lower than that in nerve block group (P < 0.05).

ConclusionsLumbar plexus-sciatic nerve block and combined spinal-epidural anesthesia can be used in elderly patients treated with femoral head replacement.The two anesthesia methods have not significant effects on the hemodynamics of patients, the amount of analgesic drugs in combined spinal-epidural anesthesia is less, and the analgesic effect is significant.In the actual clinical anesthesia, we should fully consider the actual situation of patients to choose the appropriate anesthesia.