To explore the effect of neurostimulator positioning on the postoperative immune function of elderly patients undergoing hip replacement with lumbar plexus combined with sciatic nerve block.

Eighty-six elderly patients who underwent hip arthroplasty from February 2016 to October 2018 were enrolled in the study. They were grouped according to a random number table, with 43 patients in each group. Among them, the control group underwent epidural anesthesia, and the observation group underwent neurostimulator positioning under the lumbar plexus combined with sciatic nerve block anesthesia. The T lymphocyte subsets, inflammatory factor levels, sensory nerves, motor block time, infection and other adverse reactions occurred at different time points in the two groups.

The levels of CD₃⁺, CD₄⁺, CD₄⁺/CD₈⁺ in T lymphocyte subsets in the observation group were significantly higher than the control group at the T₁ and T₂ time points (P<0.05). The levels of inflammatory factors IL-6 and TNF-α were significantly lower than the control group, which was statistically significant (P<0.05). In the observation group, the onset time of sensory nerve block and motor block was significantly faster than the control group (P<0.05); the maintenance time was significantly longer than the control group (P<0.05). And the incidence of adverse reactions such as observation group infection was significantly lower than the control group, which was statistically significant (P<0.05).

The neurostimulator positioning of the lumbar plexus combined with sciatic nerve block anesthesia is superior to epidural anesthesia in elderly patients undergoing hip replacement surgery, which is beneficial to maintain the level of T lymphocyte subsets, reduce the immune function, and reduce the inflammatory response. And the occurrence of adverse reactions such as infection is an ideal anesthesia method for elderly hip replacement.