The effect of brachial plexus block combined with laryngeal mask anesthesia on upper extremity surgery in the aged

Abstract

Objective To explore the clinical effect of the brachial plexus block with laryngeal mask airway(LMA) anesthesia in the aged undergoing the upper extremity fracture surgery.Methods Fifty aged patients undergoing the upper extremity fracture surgery were enrolled in the study.The patients were divided randomly into the brachial plexus block with intubation anesthesia group (group A) and the brachial plexus block with laryngeal mask airway anesthesia group (group B).Heart rate (HR),mean arterial pressure (MAP) levels were measured at immediately before anesthesia induction (T0),immediately after anesthesia induction (T1),immediately after intubation or inserting LMA (T2),the set of operation (T3),15 min during operation(T4) and withdrawal(T5).And the perioperative dosage of propofol,recovery time and incidence of postoperative agitation were recorded.Results All patients were successfully operated with no intraoperative awareness.There was more stable hemodynamic index in group B.MAP,HR at T2 was smaller in group B than that in group A[(85.9 ±-8.3) mm Hg(1 mm Hg =0.133 kPa) vs.(102.5 ± 9.0) mm Hg,(84.5 ± 15.0)beats/min vs.(94.2 ± 14.3) beats/min] (P ＜ 0.05).The dosage of propofol was smaller,the recovery time was shorter,and the incidence of postoperative agitation was lower in group B than that in group A[(321.7 ±47.2) mg vs.(382.4 ± 52.6) mg,(7.3 ± 2.9) min vs.(13.2 ± 3.7) min,12.0％ (3/25) vs.36.0％ (9/25)],there were significant differences (P＜ 0.05).Conclusion The brachial plexus block with LMA anesthesia can be safe and effective in the aged undergoing the upper extremity fracture surgery. Key words: Aged; Anesthesia,general; Upper extremity surgery; Laryngeal mask