Objective To investigate the anesthetic effect of lumbar plexus block (LPB) with different concentrations of dexmedetomidine combined undergoing ropivacaine in elderly patients wndergoing intertrochanteric femoral fracture. Methods A total of 180 elderly patients with intertrochanteric fracture of femur were enrolled as research subjects and divided into groups D0, D1, D2, and D3 by using a random number table method, with 45 cases in each group. All four groups underwent LPB. Specifically, the D0 group received 0.375% ropivacaine; the D1 group was treated with 0.375% ropivacaine containing 0.5 μg/mL dexmedetomidine; the D2 group received 0.375% ropivacaine containing 1.0 μg/mL dexmedetomidine; the D3 group received 0.375% ropivacaine containing 1.5 μg/mL dexmedetomidine. The onset time and duration of nerve block anesthesia, anesthetic recovery time, and spontaneous breathing recovery time were compared between the four groups. Pain intensity was evaluated by using the visual analogue scale (VAS) at preoperative (H0), 6 hours postoperatively (H1), 12 hours postoperatively (H2), and 24 hours postoperatively (H3), respectively; the quality of anesthetic recovery was assessed with the quality of recovery scale-15 (QoR-15) at 24 hours postoperatively (H3), as well as the incidences of shivering, nausea and vomiting, and bradycardia were compared between the four groups. Results The onset time of nerve block anesthesia in group D0, D1, D2 and D3 was sequentially shortened (P<0.05). The duration of nerve block anesthesia in group D0 was shorter than that in the other three groups, and the duration in group D1 was shorter than that in groups D2 and D3 (P<0.05). The spontaneous breathing recovery time and the anesthetic recovery time in group D0 were shorter than those in the other three groups, while group D1 and D2 had shorter times than group D3 (P<0.05). At H1, H2 and H3, the pain VAS scores in group D0, D1, D2 and D3 decreased sequentially (P<0.05). Within each of the four groups, the pain VAS scores decreased sequentially at H0, H1, H2, and H3 (P<0.05). The QoR-15 scores in group D0, D1, D2 and D3 increased sequentially (P<0.05). The total incidence of adverse reactions in group D3 was higher than that in group D0 and D1 (P<0.05). Conclusion For elderly patients with intertrochanteric femoral fracture undergoing surgical treatment, LPB with different concentrations of dexmedetomidine combined with ropivacaine can shorten the onset time of nerve block anesthesia, prolong its duration, enhance the postoperative analgesic effect and improve the quality of anesthetic recovery. However, moderate concentration (1.0 μg/mL) of dexmedetomidine yields greater benefits for patients, and high concentration (1.5 μg/mL) of dexmedetomidine may prolong the anesthetic recovery time and spontaneous breathing recovery time, and increase the incidence of bradycardia as an adverse reaction.

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