Applicability and Effectiveness of Ultrasound Combined Nerve Stimulator-Guided Lumbosacral Plexus Block in Supine Versus Lateral Position During Surgeries for Lower Limb Fracture-A Prospective Randomized Controlled Trial

Background: To compare the applicability and effectiveness of ultrasound combined nerve stimulator-guided lumbosacral plexus block (LSPB) in supine versus lateral position during the lower limb fracture surgery. Methods: Patients who underwent elective internal fixation for lower limb fracture were divided into the S group and the L group by the random number table method and received LSPB guided by ultrasound combined nerve stimulator in supine and lateral positions, respectively. The primary outcome examined was the dose of sufentanil used in surgery and the secondary outcomes were the maximum VAS pain score at position placing for LSPB, the time of position placing, the time for nerve block and the number of puncture attempts. Results: The maximum pain score at position placing, the time of position placing for nerve block, the time for lumbar plexus block and the time of puncture attempts were significantly lower in the S group compared with those of the L group (all P <0.05). However, the time for sacral plexus block was higher in the S group compared with that of the L group ( P <0.05). The heart rate and mean arterial pressure at different time points, times of puncture attempts for sacral plexus, dose of sufentanil used, VAS scores, the satisfactory postoperative degree to analgesia and adverse events of nerve block did not significantly differ between the two groups (all P >0.05). Conclusions: LSPB in the supine position is simple to apply and has definite anesthetic effects. Meanwhile, it has a high comfort level and therefore should be widely applied. The trial was registered prior to patient enrollment at the Chinese Clinical Trail Registry (Date:11/03/2021 Number: ChiCTR2100044117).