Abstract
Objective. The study aimed to explore the application of ultrasound image-guided general drug anesthesia combined with lumbar and sacral plexus block based on MATrix LABoratory (MATLAB) algorithm in hip arthroplasty and to study its clinical effect. Methods. The classic geodesic active contour (GAC) algorithm and the improved fuzzy clustering level set algorithm were used to segment ultrasound images of waist plexus, and then their segmentation effects were compared. Both algorithms are from the MATrix LABoratory (MATLAB) platform. A total of 60 patients undergoing hip arthroplasty were selected and randomly enrolled into control and experimental groups. The control group accepted general drug anesthesia, and the experimental group accepted ultrasound-guided lumbar and sacral plexus block combined with general anesthesia. The mean arterial pressure and heart rate at t0 (before anesthesia), t1 (before ventilation), t2 (when the skin was incised), t3 (when the prosthesis was implanted), t4 (when the incision was closed), and t5 (at the end of ventilation) were observed, and the intraoperative sufentanil dosage and 24 h analgesic dosage, the incidence of postoperative delirium, and the incidence of cognitive dysfunction were recorded. Results. The improved fuzzy clustering level set algorithm was better than the GAC model algorithm in image segmentation and running time. In contrast with the control group, the average arterial pressure and heart rate of the experimental group at the four time points of t1, t2, t3, and t5 were obviously reduced ( P < 0.05). In contrast with the control group, the amount of sufentanil and analgesics in the experimental group was obviously reduced ( P < 0.05), and the incidence of postoperative cognitive dysfunction and delirium was obviously reduced ( P < 0.05). Conclusion. The improved fuzzy clustering level set algorithm is superior to the GAC model in image segmentation and running time. Under its guidance, the lumbar and sacral plexus block combined with general anesthesia has a good clinical effect in hip arthroplasty, which is better than simple general anesthesia.
Highlights
Hip fracture is a frequently occurring disease in clinic. e clinical manifestations of patients are swelling of the limbs, restricted movement, and pain, which are more common in elderly patients, often accompanied by the decline of various organs [1]
A total of 60 patients undergoing hip arthroplasty in the hospital from March 2019 to March 2020 were selected, and 30 of them were enrolled into a control group and the remaining were enrolled into an experimental group. e control group had 17 males and 13 females, with an average age of (51.2 ± 3.7) years, there were 16 males and 14 females in the experimental group, with an average age of (52.8 ± 2.4) years, and there was no obvious difference in general information
Based on MATrix LABoratory (MATLAB) simulation, the clustering results showed that it was close to the edge of the target area, but due to the characteristics of uneven ultrasound image and large noise, some noises appeared in the nontarget area, as shown in Figure 3. e above clustering results after level set evolution suggested that the smaller area can be filtered out to make the edge of the target area clearer. erefore, the algorithm based on improved fuzzy clustering level set was better than the algorithm based on geodesic active contour (GAC) model in image segmentation
Summary
Hip fracture is a frequently occurring disease in clinic. e clinical manifestations of patients are swelling of the limbs, restricted movement, and pain, which are more common in elderly patients, often accompanied by the decline of various organs [1]. The main method to treat this disease is total hip arthroplasty (THA). It can effectively improve hip joint function and reduce intraoperative bleeding, with less complications. Most patients with hip fracture are the elderly, who are accompanied by various chronic diseases, low immunity, poor liver and kidney function [2,3,4], high blood loss, obvious stress response, and more sensitivity to anesthetics. Lumbar plexus block (LPB) is currently the most commonly used anesthesia method for THA. Compared with traditional simple general anesthesia and intraspinal anesthesia, lumbar block combined with general anesthesia facilitates respiratory management and effectively reduces circulatory depression. Lumbar plexus block combined with general anesthesia can be widely used in lower extremity surgery
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