Cardiovascular Effects of Combined Lumbar Plexus-Sciatic Nerve Block versus Spinal Block in Patients Undergoing Hip Surgery

Abstract

The objective of this study was to compare cardiovascular effects of regional anesthesia using combined lumbar plexus-sciatic nerve block with spinal block in geriatric patients undergoing hip surgery in Lumphun Hospital. The study was conducted as a randomized double blinded trial. One hundred patients were enrolled in the study; and were randomly assigned as the study group using combined lumbar-sciatic plexus block and the control group using spinal block. In both groups, demographic data, hemodynamic parameters, pain score and amount of morphine consumption in 24 hours were recorded. Pain control was assessed by first request for analgesia, pain score and total morphine consumption in 24 hours. The data were analyzed using Chi-square and unpaired T-test. It was found that here was no cardiovascular complication in both groups; and the study group had less change of systolic, diastolic and mean arterial blood pressures. Differences in postoperative duration until pain score > 4 was not significant. The 24- hr pain score were 4.08±0.83 and 4.40±0.67 in the study and control groups respectively (p=0.03). Total morphine consumption in 24hr was less in the study group. In summary, regional anesthesia by combined lumbar-sciatic plexus block could better stabilize blood pressure in aging patients during hip surgery. This technique also demonstrated less cardiovascular complication, less pain and less analgesics needs after surgery.