摘要
目的比较超声引导定位坐骨神经阻滞与鞘膜突破定位坐骨神经阻滞在老年髋关节置换术的效果。方法选择2015年7月至2016年4月该院骨科收治择期拟行髋关节置换术患者90例作为研究对象,采用随机数字表法分为超声组和鞘膜突破组,每组均为45例,超声组实施超声引导定位坐骨神经阻滞,鞘膜突破组实施鞘膜突破法定位坐骨神经阻滞。观察两组一次操作置管成功率、平均置管操作时长、导管留置时间、术后镇痛有效率、患者满意度、镇痛情况,并对两组注药后不良反应的发生情况进行统计比较。结果超声组一次操作置管成功率明显高于鞘膜突破组(P<0.05),此外超声组导管留置时间亦明显短于对照组(P<0.05),平均置管操作时长、术后镇痛有效率、视觉疼痛模拟评分、患者满意度比较,两组差异无统计学意义(P>0.05);术后超声组出现1例呕吐患者,鞘膜突破组出现2例呕吐患者,症状轻微,均未进行处理,不久后症状消失,两组不良反应的发生率比较,差异无统计学意义(P>0.05)。结论老年髋关节置换术采用鞘膜突破定位及超声引导定位坐骨神经阻滞的镇痛效果相似,但超声引导定位可缩短导管留置时间,一次操作成功率更高。
Objective To compare the effects of the sciatic nerve block guided by ultrasound and tunica vaginalis breakthrough in the elderly hip replacement surgery.Methods Selected 90 cases of patients who were treated in our orthopedic department from July 2015 to April 2016 who were undergone hip replacement surgery as the research objects.According to the random number table method,they were randomly divided into the ultrasound group and the tunica vaginalis breakthrough group,with 45 cases in each group.The ultrasound group was used ultrasound guide to locate sciatic nerve block while the tunica vaginalis breakthrough group was implemented the way of tunica vaginalis breakthrough to locate sciatic nerve block.Observed the success rate of catheter operating at one time,the average operation time to place catheter,catheter indwelling time,the effective postoperative analgesia,the patient satisfaction and analgesia,and counted and compared the adverse reaction of two groups after drug.Results The success rate of placing catheter at one time of the ultrasound group was obviously higher than that of the tunica vaginalis breakthrough group(P<0.05).In addition,the catheter indwelling time of the ultrasound group was also significantly shorter than that of the control group(P<0.05).There was no significant differences on the average catheter operation duration,postoperative analgesia efficient,VAS scores and patient satisfaction between the two groups(P>0.05).The ultrasonic group had 1 patients with vomiting after operation,while the tunica vaginalis breakthrough group had 2 patients with vomiting.The symptoms were mild and have not been processed but they disappeared soon.There is no significant difference in the incidence of adverse reactions between two groups(P>0.05).Conclusion The analgesic effect is similar to apply ultrasound guide and tunica vaginalis breakthrough to place the sciatic nerve block in the elderly hip replacement and the clinical effects are also better.But the ultrasound guided localization method can sh
作者
王红霞
WANG Hongxia(Department of Anesthesia,Central Hospital of Zaozhuang Mining Group,Zaozhuang,Shandong 277000,China)
出处
《检验医学与临床》
CAS
2018年第8期1089-1091,共3页
Laboratory Medicine and Clinic
