Lumbar-Sacral Plexus Block Anesthesia versus General Anesthesia for Total Hip Arthroplasty: Case Control Study

作     者：Perales Caldera Eduardo González Lumbreras Aniza Surinam Uribe Campo Giselle Andrea Fernández Soto José Rodrigo Medina de la Rosa Edoardo Díaz Borjón Efraín Bravo Reyna Carlos César Perales Caldera Eduardo;González Lumbreras Aniza Surinam;Uribe Campo Giselle Andrea;Fernández Soto José Rodrigo;Medina de la Rosa Edoardo;Díaz Borjón Efraín;Bravo Reyna Carlos César

作者机构：Department of Anesthesiology Hospital ángeles Lomas México City Mexico Department of Orthopaedics Hospital ángeles Lomas México City Mexico Department of Experimental Surgery Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán México City Mexico 

出 版 物：《Open Journal of Anesthesiology》 (麻醉学期刊（英文）)

年 卷 期：2021年第11卷第9期

页      面：259-268页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Anesthetic Technique Conversion Opioids Requirements General Anesthesia Regional Anesthesia Lumbar Plexus Block Sacral Plexus Block Lumbar Sacral Plexus Anesthesia Success Rate 

摘      要：Background: Peripheral block techniques for total hip arthroplasty have been used as an analgesic strategy, only a few studies described it as an anesthetic technique, so the perioperative performance and safety are poorly studied. Methods: 78 total hip arthroplasties were prospectively observed in our hospital. Divided into 2 groups: 1) General anesthesia;and 2) Lumbar sacral plexus block anesthesia. Variables measured in both groups were: demographics, conversion to general anesthesia, total opioid doses, surgical time, blood loss, postoperative pain, use and total dose of vasopressors drugs, transfusion and ICU transfer needs, postoperative ambulation time, and length of hospital stay. T student and chi-square tests were used upon the case. A significant difference was considered when a value of p Results: 3 patients (7.3%) anesthetized with combined lumbar sacral plexus block were converted to general anesthesia. When comparing peripheral nerve block and general anesthesia, less intraoperative (p = 0.000) and postoperative (p = 0.002) opioid consumption were noted, less postoperative pain in PACU (p = 0.002) and in the first 24 hours (p = 0.005), as well as earlier onset of ambulation (p = 0.008) and shorter hospital stay (p = 0.031). Conclusions: In our study, the lumbar and sacral plexus block anesthesia technique provided anesthetic conditions to perform hip joint arthroplasty and it was proved to be advantageous in comparison to general anesthesia.