To observe the effect of paravertebral nerve block combined with shallow general anesthesia on the anesthesia effect in patients undergoing hip replacement (HR).

One hundred patients undergoing HR were selected from March 2016 to March 2018 in Huangshi Central Hospital of Edong Medical Group, those who informed consent, 18-70 years old and with no drug allergy, psychosis history or communication barriers, were included. Those who refused or withdrawed from the study and those who had treatment history or diseases affecting the study were excluded. According to the method of random number table, the patients were divided into lumbar block & general anesthesia group and single general anesthesia group, 50 cases in each group. The single general anesthesia group were given general anesthesia, and the lumbar block & general anesthesia group were combined lumbar paravertebral nerve block with general anesthesia. The chi-square test was used for counting data, the independent sample t test was used for measurement data, the repeated measurement analysis of variance was used to analyze the time difference within each group, the LSD-t test was used for those with statistical difference, and the mean arterial pressure (MAP), heart rate (HR), fibrinogen (FIB), D-dimer (DD), tumor necrosis factor alpha (TNF-α), interleukin -6 (IL-6), dosage of drugs, excellent rate of analgesia, incidence of adverse reactions and the time of opening eyes, clenching, extubating, awakening were compared between the two groups.

The MAP、HR、TNF-α、IL-6、FIB、DD in the lumbar block & general anesthesia group were significantly lower than those in the single general group when at 10min after anesthesia (T1), at the time of hip replacement (T2), at the end of the operation (T3), the difference is statistically significant (t=8.422, 9.782, 7.242, 5.762, 7.572, 5.242, 4.913, 5.995, 5.206, 5.908, 5.154, 5.658, 4.200, 9.363, 3.675, 3.332, 8.642, 4.022, all P <0.001). The excellent rate of analgesia in the lumbar block & general anesthesia group was higher than that in the single general group, the difference is statistically significant (χ²=6.061, P<0.05). The dosage of drugs, the incidence of adverse reactions and the time of opening eyes, clenching, extubating, awakening in the lumbar block & general anesthesia group were significantly lower than those in the single general group, the difference is statistically significant (χ²=6.250, P<0.05; t=9.299, 8.093, 13.397, 28.452, 14.349, all P<0.001).

Lumbar paravertebral nerve block combined with shallow general anesthesia can effectively improve the analgesic effect of HR patients and relieve the stress response of inflammation, it is beneficial to reduce the dosage of drugs and adverse reactions, and can effectively promote the patient’s recovery.