摘要
目的探究超声引导下罗哌卡因股神经坐骨神经阻滞对老年髋关节手术患者血流动力学的影响。方法将2017年2月至2019年2月于该院择期行髋关节手术的110例老年患者按抽签法随机分为观察组与对照组,各55例。观察组采用超声引导下罗哌卡因股神经坐骨神经阻滞,对照组采用腰麻-硬膜外联合麻醉。比较两组麻醉效果、麻醉前(T0)、麻醉15 min后(T1)、麻醉30 min后(T2)时血流动力学指标变化[收缩压(SBP)、舒张压(DBP)、心率(HR)、血氧饱和度(SpO2)],记录并比较两组不良反应发生率。结果观察组麻醉优良率(98.18%)显著高于对照组(87.27%),差异有统计学意义(P<0.05);与T0时刻比较,两组T1、T2时刻SBP、DBP、HR、SpO2均显著降低,且观察组T1、T2时刻SBP、DBP、HR、SpO2均显著高于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率(5.45%)显著低于对照组(20.00%),差异有统计学意义(P<0.05)。结论对老年髋关节手术患者应用超声引导下罗哌卡因股神经坐骨神经阻滞可显著提高麻醉效果,并帮助稳定患者血流动力学,不良反应较少。
【Objective】To explore the effects of ultrasound-guided ropivacaine for femoral nerve sciatic nerve block on hemodynamics in elderly patients undergoing hip surgery.【Methods】A total of 110 elderly patients who underwent elective hip surgery in our hospital from February 2017 to February 2019 were randomly divided into observation group and control group according to the lottery method,with 55 cases in each group.Observation group was given ultrasound-guided ropivacaine for femoral nerve sciatic nerve block,and control group was given combined spinal-epidural anesthesia.The anesthetic effects and changes of hemodynamic parameters[systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),blood oxygen saturation(SpO2)]before anesthesia(T0),15 min after anesthesia(T1)and 30 min after anesthesia(T2),and the incidence rate of adverse reactions was recorded and compared between the two groups.【Results】The excellent and good rate of anesthesia in observation group was significantly higher than that in control group(98.18%vs.87.27%)(P<0.05).Compared with those at T0,the levels of SBP,DBP,HR and SpO2 were significantly decreased at T1 and T2,and the levels of SBP,DBP,HR and Sp O2 in observation group at T1 and T2 were significantly higher than those in control group(P<0.05).The incidence rate of adverse reactions in observation group was significantly lower than that in control group(5.45%vs.20.00%)(P<0.05).【Conclusion】Ultrasound-guided ropivacaine for femoral nervesciatic nerve block in elderly patients with hip surgery can significantly improve the anesthetic effects and help stabilize hemodynamics,and it has fewer adverse reactions.
作者
杨艳
YANG Yan(Department of Anesthesiology,Anyang District Hospital in Puyang City,Anyang,Henan 455000,China)
出处
《中国医学工程》
2019年第10期13-16,共4页
China Medical Engineering
