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

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.
Key words: Combined lumbar plexus-sciatic nerve block, spinal block, cardiovascular effects