To evaluate the clinical efficacy of ultrasound-guided sciatic and femoral nerve block anesthesia in the treatment of elderly patients with lower extremity fractures.

Thirty-four elderly patients with fractures of unilateral knee or below the knee were included in this study. There were 21 men and 13 women, and they ranged in age from 68 to 83 years old, with an average age of (74.08±7.70). All the patients underwent sciatic and femoral nerve block anesthesia. The anesthesia operation, onset, and duration were recorded. The visual acuity was simulated and the changes of vital signs were evaluated. The intensity of preoperative, intraoperative, and postoperative pain was also evaluated using the visual analogue scale (VAS). Blood pressure, blood oxygen saturation before and after anesthesia at different time points, time to food intake, and postoperative complications were recorded. Heart rate, systolic blood pressure, diastolic blood pressure, and blood oxygen saturation at different time points were compared using one-way repeated measures analysis of variance. The VAS score was compared using the t-test.

The operation time for sciatic nerve block and femoral nerve block was (6.0±1.2) min and (1.5±1.4) min, respectively; the onset time was (15.0±6.2) min and (7.1±6.2) min, and the duration time was (16.0±7.2) h and (7.0±5.2) h, respectively. The VAS scores before surgery, at 30 minutes after the beginning of surgery, and after surgery were (2.1±1.2), (1.9±0.6), and (1.8±0.7), respectively, and there was no statistical difference between them. Heart rate, systolic blood pressure, diastolic blood pressure, and blood oxygen saturation at different time points did not differ significantly (P>0.05). GradeⅠnerve block effect was achieved in 31 (91.17%) cases, and gradeⅡwas achieved in three (8.83%) cases. The adverse reaction of the patients after operation were less, and the symptoms were obviously alleviated after treatment.

Ultrasound-mediated sciatic and femoral nerve block can provide satisfactory anesthetic effect for patients with unilateral lower limb fractures, with less disturbance to vital signs and fewer postoperative complications.