摘要
目的探讨超声引导下股外侧皮神经-股神经阻滞在老年患者股骨近端防旋髓内钉(PFNA)术的麻醉效果及安全性。方法选择2017年4月至2019年9月在西部战区总医院行PFNA术的老年患者68例,采用计算机随机数表分为神经阻滞联合喉罩全身麻醉组(NL组)与单纯喉罩全身麻醉组(L组)。观察两组患者心率(HR)、平均动脉压(MAP)、脉搏氧饱和度(SpO2)的变化;记录手术结束后瑞芬太尼用量;比较入麻醉复苏室(PACU)时视觉模拟评分法(VAS)评分及不良反应情况。结果在切皮、术毕和喉罩拔除时,L组HR、MAP均明显高于NL组(P<0.05);两组各时间点SpO2无明显差异(P>0.05)。NL组术中瑞芬太尼用量明显少于L组,停药后苏醒时间明显短于L组(P<0.05),苏醒期躁动、嗜睡发生率及入PACU时VAS评分均明显低于L组(P<0.05)。结论超声引导下股外侧皮神经-股神经阻滞联合喉罩全身麻醉可安全用于老年患者PFNA术,为老年患者提供了较理想的麻醉方式。
Objective To investigate the anesthetic effect and safety of ultrasound-guided lateral femoral cutaneous nerve-femoral nerve block in elderly patients undergoing proximal femoral nail rotation(PFNA).Methods A total of 68 elderly patients undergoing PFNA from April 2017 to September 2019 were randomly divided into the nerve block combined with laryngeal mask anesthesia group(group NL)and the simple laryngeal mask anesthesia group(group L).The changes of heart rate(HR),mean arterial pressure(MAP)and pulse oxygen saturation(SpO2)were observed;the dosage of remifentanil after operation was recorded;the score of visual analogue scale(VAS)and adverse effects at admission to post-anesthesia care unit(PACU)were compared.Results At the time of skin incision,end of operation and laryngeal mask pulling out,HR and MAP in group L were significantly higher than those in group NL(P<0.05).There was no significant difference in SpO2 at any time point between the two group(P>0.05).The dosage of Remifentanil in group NL was less than that in group L and the recovery time after drug withdrawal was shorter than that in group L(P<0.05).The incidence of restlessness and somnolence during the period of recovery and the VAS score at admission to PACU were lower than those of group L(P<0.05).Conclusion Ultrasound-guided femoral nerve-lateral femoral cutaneous nerve block can be safely used for PFNA in elderly patients,which provides an ideal anesthesia method.
作者
汪海洋
辜敏
陈亮
查鹏
林露
龚华渠
巩固
WANG Haiyang;GU Min;CHEN Liang;ZHA Peng;LIN Lu;GONG Huaqu;GONG Gu(Department of Anesthesiology,Western Theater General Hospital,Chengdu,Sichuan 610083,China;Department of Anesthesiology,Chengdu First People′s Hospital,Chengdu,Sichuan 610000,China)
出处
《重庆医学》
CAS
2021年第2期259-262,共4页
Chongqing medicine
基金
军队后勤科研项目(CCD16J001)。
关键词
股骨骨折
老年人
超声引导
神经阻滞
股骨近端防旋髓内钉
femoral fractures
aged
ultrasound-guided
nerve block
proximal femoral nail anti-rotation
