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Surgical Research and New Technique

Surgical Research and New Technique ›› 2019, Vol. 8 ›› Issue (1): 31-35.doi: 10.3969/j.issn.2095-378X.2019.01.010

• Original article • Previous Articles     Next Articles

Comparison of lumbar plexus-sciatic nerve block versus subarachnoid nerve block in lower limb sugery

TAN Jian1, LI Xiuman2   

  1. 1.Department of Anesthesiology, The Third Affiliated Hospital of Guizhou Medical University, Duyun 558000, China;
    2.Teaching and Research Office, Hunan University of Medicine, Huaihua 418000, China
  • Received:2018-12-26 Online:2019-03-28 Published:2019-12-09

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Abstract: Objective To compare the clinical effects of lumbar plexus-sciatic nerve block versus subarachnoid nerve block on unilateral lower limb surgery.Methods A total of 60 patients with ASA I-II who underwent unilateral lower extremity surgery were randomly divided by random number table into lumbar plexus-sciatic nerve block group (group A) and subarachnoid nerve block group (group B), with 30 cases in each group.Group A underwent nerve stimulator-assisted lumbar plexus-sciatic nerve combined block, using 0.5% ropivacaine at 20 mL for lumbar plexus block and 0.5% ropivacaine at 15 mL for sciatic nerve block; while group B received subarachnoid nerve block anesthesia, with 0.5% ropivacaine at 10-15 mL.Heart rate (HR), mean arterial pressure (MAP), respiration rate (RR), and oxygen saturation (SPO2) were recorded at 5 min before anesthesia (T0), 5 min after anesthesia (T1), beginning of surgery (T2), 30 min after the start of surgery (T3), and end of surgery(T4); sensory and motor block onset time, sensory and motor recovery time, sufentanil usage, ephedrin usage, and postoperative adverse events (nausea, pruritus, hypotension, and urinary retention) were also recorded.Results The sensory and motor block onset time in group A was statistically shorter than that in group B (P<0.05).At T0, HR, MAP, RR, and SPO2 were not different between group A and group B (P>0.05); at T1, T2, T3, and T4, HR in group A was significantly lower than that in group B (P<0.05); at T4, MAP in group A was significantly higher than in that in group B (P<0.05).The sufentanil use rate was not different between the two groups, but the ephedrin use rate in group A was significantly lower than that in group B (P<0.05).The rates of adverse reactions in group A (nausea, pruritus, urinary retention, and hypotension) were significantly lower than those in group B (P<0.05).Conclusion Compared with subarachnoid nerve block, lumbar plexus-sciatic nerve block shows more stable hemodynamics and less postoperative complications in unilateral lower limb surgery.

Key words: Lumbar plexus block, Sciatic nerve block, Subarachnoid nerve block, Nerve stimulator

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