摘要
目的研究超声引导腹股沟上髂筋膜阻滞联合喉罩全身麻醉对老年患者全髋关节置换术后早期恢复质量的影响。方法选择2019年1月至2020年6月淮安市淮阴医院择期全身麻醉下行全髋关节置换术老年患者50例,采用随机数字表法将患者分为试验组(E组)和对照组(C组),每组各25例。E组在全身麻醉前行超声引导下腹股沟上髂筋膜阻滞,定位成功后注入0.3%盐酸罗哌卡因40 ml;C组直接行全身麻醉。记录两组患者术前1天、术后第1天、术后第2天40项恢复质量评分量表(QoR-40)评分及其子指标评分;术中舒芬太尼用量、术中机械通气时长(min)、手术时长(min)以及术后住院日(d)。结果与术前相比,术后第一天E组身体舒适度疼痛状态评分、QoR-40总分明显升高(P<0.05);与术前相比,术后第2天E组身体舒适度评分、疼痛状态评分、QoR-40总分明显升高(P<0.05);术后第一天,E组身体舒适评分、疼痛状态评分明显高于C组(P<0.05);术后第2天,E组疼痛状态评分、QoR-40总分明显高于C组(P<0.05);E组术中舒芬太尼用量以及机械通气时长明显少于C组(P<0.05)。结论与单独全身麻醉比较,超声引导腹股沟上髂筋膜阻滞联合喉罩全身麻醉可以提高老年患者全髋关节置换术后Qo-R40评分,减少术中舒芬太尼用量,缩短术中机械通气时长,有利于改善术后早期恢复质量。
Objective To study the effect of ultrasound-guided supra-inguinal iliac fascia block combined with laryngeal mask general anesthesia on the quality of early recovery after total hip arthroplasty in elderly patients.Methods A total of 50 elderly patients undergoing elective total hip arthroplasty under general anesthesia in Huaiyin Hospital of Huai'an from January 2019 to June 2020 were selected as the study subjects.They were divided into the experimental group(group E)and the control group(group C)according to the random number table method,with 25 cases in each group.Patients in group E underwent ultrasound-guided supra-inguinal iliac fascia block before general anesthesia,and were injected with 40 ml of 0.3%ropivacaine hydrochloride after successful positioning.Patients in group C directly received general anesthesia.The scores of 40-item Quality of Recovery Score(QoR-40)and its subindex scores in both groups at one day before operation,one day and two days after operation were recorded.The sufentanil dosage and mechanical ventilation duration(min)during operation,operating duration(min)and postoperative hospital stay(d)in both groups were also recorded.Results The comfortscores,The pain scores and total QoR-40 scores were significantly higher in group E at one day after operation than those before operation(P<0.05).The physical comfort scores,pain scores and total QoR-40 scores were significantly higher in group E at two days after operation than those before operation(P<0.05).At one day after operation,the physical comfort scores and pain scores were significantly higher in group E than those in group C(P<0.05).At two days after operation,the pain scores and total QoR-40 scores in group E were significantly higher than those in group C(P<0.05).The sufentanil dosage and mechanical ventilation duration in group E were significantly less than those in group C(P<0.05).Conclusion Compared with general anesthesia alone,ultrasound-guided supra-inguinal iliac fascia block combined with laryngeal mask general anesthe
作者
叶炜
陈金红
肖计文
孙美娟
姚盛来
YE Wei;CHEN Jinhong;XIAO Jiwen;SUN Meijuan;YAO Shenglai(Department of Anesthesiology,Huaiyin People's Hospital of Huai'an,the Fifth People's Hospital of Huai'an City,Jiangsu,Huai'an 223300,China;Department of Anesthesiology,Huaiyin Hospital of Huai'an,Jiangsu,Huai'an 223300,China)
出处
《中国医药科学》
2021年第18期95-98,155,共5页
China Medicine And Pharmacy
