摘要
目的:分析超声引导下经腹股沟韧带上髂筋膜间隙联合梨状肌上孔骶丛神经及臀上皮神经阻滞在老年全髋关节置换术中的应用。方法:选取2020年3月-2021年3月笔者所在医院40例行单侧全髋关节置换术患者为研究对象,采用区组随机化分组法将其分为对照组和试验组,各20例。对照组采用常规气管插管静吸复合全身麻醉,试验组则采用超声引导下经腹股沟韧带上髂筋膜间隙联合梨状肌上孔骶丛神经及臀上皮神经阻滞麻醉,术后均行静脉镇痛(PCIA)。术中观察记录两组患者入室时(T0)、静脉开始泵注右美托咪定即刻(T_(1))、切皮时(T_(2))、切皮后30 min(T_(3))的心率(HR)、收缩压(SBP)、舒张压(DBP),比较两组术后2、6、12、24、48 h疼痛程度[视觉模拟评分法(VAS)],比较术后PCIA使用情况、术后首次进食时间、首次排尿时间、首次下床活动时间、住院时间,比较术后24 h两组患者不良反应发生情况及术后3 d意识状态[老年谵妄测验(CAM-CR)]。结果:试验组T_(1)、T_(2)、T_(3)时HR、SBP、DBP与T0时比较,差异无统计学意义(P>0.05),对照组T_(1)、T_(2)、T_(3)时HR、SBP、DBP较T0时均有明显升高(P<0.05),且均高于同一时间试验组(P<0.05);试验组术后2、6、12 h疼痛程度明显低于对照组(P<0.05),术后24、48 h两组疼痛程度比较差异无统计学意义(P>0.05);试验组术后PCIA使用次数、首次进食时间、首次排尿时间、首次下床活动时间及住院时间均明显优于对照组(P<0.05);术后24 h,试验组不良反应发生率明显低于对照组(P<0.05)。术后3 d,试验组CAM-CR评分明显低于对照组(P<0.05)。结论:在老年全髋关节置换术中实施超声引导下经腹股沟韧带上髂筋膜间隙联合梨状肌上孔骶丛神经及臀上皮神经阻滞对患者生命体征影响较小,术后镇痛效果明显,能加快患者术后恢复,且安全性较高,麻醉不良反应和术后谵妄的发生率较小,具有较高临床
Objective:To analyze the application of ultrasound guided suprailiac fascia space through the groin ligament combined with the superior hole of pear like muscle and sacrum plexus and gluteus epithelial nerve block in the elderly total hip arthroplasty.Method:A total of 40 patients with unilateral total hip arthroplasty in our hospital from March 2020 to March 2021 were selected as the research object.The randomized group of the area group was used to divide them into the control group and the experimental group,20 cases in each group.The control group was treated with conventional tracheal intubation and general anesthesia,while the experimental group was anesthetized by the use of the anesthesia method of the ultrasound guided suprailiac fascia space through the groin ligament and the superior hole of the pear like muscle,sacral plexus and gluteus epithelial nerve block,and the postoperative intravenous analgesia(PCIA)was performed.The heart rate,systolic pressure(SBP),diastolic pressure(DBP)of patients in the two groups were recorded during the operation(T0),Dexmedetomidine was injected into the right side of the vein(T_(1)),at the time of skin cutting(T_(2)),30 minutes after skin incision(T_(3)),and the pain degrees[visual analogue score(VAS)]were compared between the two groups at 2,6,12,24,48 hours after operation,and the use of PCIA,the first time of eating,the first time of urination,the first time to get out of bed and the time of hospitalization were compared.The adverse reactions and consciousness state of 24 hours after operation and the consciousness state[senile delirium test(CAM-CR)]3 days after operation of the two groups were compared.Result:HR,SBP and DBP in the experimental group were not have significantly differences at T_(1),T_(2),T_(3) compared with T0(P>0.05),HR,SBP and DBP in control group were significantly higher than that at T0(P<0.05)and which were higher than those in the same time of the experimental group(P<0.05).The pain level of the experimental group were significantly lower than
作者
何志龙
黄俊明
周振苇
肖艳霞
HE Zhilong;HUANG Junming;ZHOU Zhenwei;XIAO Yanxia(Dongguan Fenggang Hospital,Dongguan 523695,China;不详)
出处
《中外医学研究》
2021年第28期1-5,共5页
CHINESE AND FOREIGN MEDICAL RESEARCH
基金
东莞市科技局项目(202050715034607)。
