Abstract: Objective To explore and compare the application effect of two compound anesthesia methods in the minimally invasive treatment of elderly patients with tibial plateau fractures under arthroscopy. Methods A total of 126 elderly patients with tibial plateau fracture admitted to Yanqi Hospitalof the Second Division of Xinjiang Construction Corps from May 2019 to October 2021 were selected as the research objects. According to the random number table method, they were divided into general anesthesia group and nerve block group, 63 cases in each group. All patients were treated with arthroscopic minimally invasive incision and internal fixation. The general anesthesia group was treated with simple general anesthesia, and the nerve block group was treated with ultrasound-guided nerve block anesthesia on the basis of the control group. The nerve block related indexes, operation time, intraoperative blood loss, postoperative hospital stay, fracture healing time, postoperative VAS score and excellent and good rate of knee joint were compared between the two groups. Results The maintenance time of sensory nerve block, motor nerve block and postoperative analgesia in nerve block group were significantly higher than those in general anesthesia group (P<0.05). There was no significant difference in operation time and intraoperative blood loss between the two groups (P>0.05). The postoperative hospital stay and fracture healing time of the nerve block group were lower than those of the general anesthesia group, and the differences were statistically significant (P<0.05). The visual analogue scale (VAS) scores of the nerve block group at 1 day, 3 days and 7 days after operation were lower than those of the general anesthesia group, and the differences were statistically significant (P<0.05). The excellent and good rates of knee joint in nerve block group at 3 months and 6 months after operation were higher than those in general anesthesia group, and the differences were statistically significant (P<0.05). Conclusion Ultrasound-guided nerve block in the minimally invasive treatment of elderly patients with tibial plateau fracture under arthroscopy can effectively prolong the maintenance time of anesthesia and analgesia, promote the rehabilitation of patients, and will not increase the operation time and intraoperative blood loss, but also can relieve pain, improve the knee function of patients, which is worthy of clinical application.

Key words: general anesthesia, ultrasound-guided nerve block, elderly, tibial plateau fracture, arthroscopy, analgesia maintenance time, knee joint function