Application of Lumber Plexus, Sciatic Nerve, and Paravertebral Nerve Block for Hip Arthroplasty

  Objective  To evaluate the value of lumber plexus + sciatic nerve + paravertebral nerve block as an anesthesia technique for hip arthroplasty surgery.

  Methods  We retrospectively analyzed the perioperative data of 34 patients scheduled for a hip arthroplasty surgery. According to the different anesthesia techniques applied, patients were divided into 3 groups:general anesthesia (GA) group, epidural anesthesia (EA) group, and nerve block (NB) group. Patients in NB group were further divided into lumber plexus + sciatic nerve block (LS) group and lumber plexus + sciatic nerve + paravertebral nerve block (PVB) group.

  Results  The average age and the incidence of coexisting disease in NB group were significantly higher than those in GA and EA group (P < 0.05). Significant decreases in the variation of systolic blood pressure, diastolic blood pressure and heart rate in NB group were observed compared with GA group (13.9%±6.1% vs. 21.6%±7.0%, 15.8%±8.2% vs. 23.3%±7.2%, 14.0%±4.7% vs. 23.3%±7.8%, all P < 0.05), and the intra-operative dosage of fentanyl was significantly lower(103.8±42.7) μg vs. (295.0±55.4) μg, P < 0.05. Compared with LS group, the variations of systolic blood pressure and diastolic blood pressure significantly reduced in PVB group (9.0%±3.4% vs. 18.8%±3.3%; 9.0%±4.1% vs. 22.5%±4.2%, P < 0.05), and the fentanyl consumption was lower but without a significant difference(87.5±47.9) μg vs. (120.0±35.6) μg, P > 0.05.

  Conclusions  Peripheral nerve block combined with small-dose intravenous anesthesia is a safe and effective anesthetic technique for hip arthroplasty surgery, and lumbar plexus + sciatic nerve + paravertebral nerve block probably can be a more effective regional anesthetic technique.