Objective To compare the anesthetic effect of lumbar plexus-sciatic nerve block anesthesia and combined spinal-epidural anesthesia respectively combined with dexmedetomidine for patients with femoral neck fracture.

Methods A total of 80 elderly patients with femoral neck fracture were randomly divided into control group and study group, with 40 cases in each group. The control group was treated with lumbar plexus-sciatic nerve block anesthesia and dexmedetomidine, while the study group was treated with combined spinal-epidural anesthesia and dexmedetomidine. The anesthesia effect, anesthesia indexes, changes of vital signs before and after anesthesia, pain scores at different time points after operation, and adverse reactions were compared between the two groups.

Results The excellent and good rate of anesthesia in the study group was 95.00%, which was significantly higher than 72.50% in the control group (P < 0.05). The onset time of anesthesia, duration of motor nerve block and duration of sensory block in the study group were significantly shorter than those in the control group, while the duration of analgesia was significantly longer than that in the control group (P < 0.05). There were no significant differences in mean arterial pressure (MAP), heart rate (HR) and blood oxygen saturation (SpO₂) before anesthesia between the two groups (P > 0.05); the MAP and HR after operation in the control group were significantly lower than those before operation in the same group and in the same period in the study group (P < 0.05). The pain scores of the study group were significantly lower than those of the control group at 2, 12 and 24 hours after operation (P < 0.05). The incidence of adverse reactions in the study group was 7.50%, which was significantly lower than 25.00% in the control group (P < 0.05).

Conclusion Combined spinal-epidural anesthesia and dexmedetomidine can better maintain the stability of physical function of elderly patients, which is more favorable for the prognosis of patients.