Application of different brachial plexus block regimens in elderly patients undergoing humeral surgery
Journal Title: Chinese Journal of Clinical Research - Year 2024, Vol 37, Issue 4
Abstract
"<b>Objective</b> To explore the analgesic effects of brachial plexus block (BPB) guided by ultrasound versus localized by nerve stimulator in elderly patients who underwent humeral surgery. <b>Methods</b> Ninety nine elderly patients scheduled for open reduction and internal fixation of humeral fractures in Tongling Municipal Hospital from May 2020 to May 2023 were selected ,and randomly divided into ultrasound group (55 cases) and stimulator group (54 cases) based on a random number table method. The ultrasound-guided BPB was performed in ultrasound group, and the nerve stimulator localization for BPB was performed in stimulator group. The blocking effect, diaphragmatic function, hemodynamics indexes, stress indexes and perioperative adverse anesthesia reactions were compared between the two groups. <b>Results</b> The onset time［(4.82±1.44)min vs(6.95±1.87)min， t=6.675］ and improvement time ［(17.62±2.57)min vs(20.54±3.79)min， t=4.689］, and dosage of 0.75% bupivacaine hydrochloride ［(21.33±2.05)mL vs(25.54±2.52)mL， t=9.592］ in ultrasound group were lower than those in stimulator group (P＜0.01). After injecting drugs for 30min, the diaphragm mobility at calm breathing position ［(1.52±0.23)cm vs(1.24±0.22)cm］and at 〖JP2〗maximum breathing position ［(4.01±0.44)cm vs(3.19±0.49)cm］in ultrasound group were higher than those in stimulator group(P＜0.01). From entering the operating room to the end of surgery, heart rate (HR) and mean arterial pressure (MAP) of the two groups decreased first and then increased (P＜0.01), and the HR and MAP of ultrasound group were significantly higher than those of stimulator group from 10 min before the start of surgery to the end of the surgery (P＜0.05). Before surgery, on the day and 2 days after surgery, levels of serum epinephrine, norepinephrine and cortisol in the two groups showed a trend of first increasing and then decreasing (P＜0.01), but no significant difference was found between the two groups at each time point (P＞0.05). There was no significant difference in the incidence of perioperative adverse anesthesia reactions (agitation, nausea and vomiting, lethargy) between the two groups (P＞0.05). <b>Conclusion</b> Ultrasound-guided BPB has a fast block onset time, few effects on diaphragmatic function, stable hemodynamics and little stress response in elderly patients undergoing humeral surgery."
Authors and Affiliations
XIAO Yu, LI Li
Keywords
Related Articles
- EP ID EP734605
- DOI 10.13429/j.cnki.cjcr.2024.04.008
- Views 86
- Downloads 0
Role and mechanism of mast cells in solid tumors
Mast cells are a type of innate immune cells, and have long been considered to be related to the pathogenesis of allergic and autoimmune diseases. However, in recent years, a number of studies have found that mast cells...
Risk factors and predictive efficacy of anastomotic fistula after radical right hemicolectomy
Objective To explore the risk factors for the occurrence of anastomotic fistula after radical right hemicolectomy, and to further assess the predictive efficacy of related factors. Methods A total of 467 patients who und...
Effect of ulinastatin on oxidative stress and intestinal flora in rats with sepsis-induced acute lung injury
Objective To investigate the effect of ulinastatin (UTI) on the level of oxidative stress as well as intestinal flora in rats with sepsis-induced acute lung injury (ALI), providing theoretical support for the diagnosis...
Diagnostic value of the combined detection of AFP and other three indexes in hepatocellular carcinoma related to hepatitis B virus
Objective To explore the clinical diagnostic value of combined serum alpha-fetoprotein (AFP), protein induced by vitamin K absence or antagonist-Ⅱ (PIVKA-Ⅱ), hepatic fibrosis 4 index (FIB-4) and tyrosine urine test (TUT)...
Research progress of gene detection in systemic therapy of pancreatic cancer
Pancreatic cancer is a common highly malignant digestive tract tumor. Due to its location and disease characteristics, it presents significant challenges in treatment. The molecular diversity of pancreatic cancer contrib...