摘要
目的分析超声联合神经刺激仪引导骶丛及股神经阻滞在骨科手术中应用的效果。方法选择2019年9月—2021年8月于该院治疗的88例骨科手术患者为研究对象,按随机数表法将其分为两组,各44例。观察组采用超声联合神经刺激仪引导骶丛及股神经阻滞,对照组采用神经刺激仪引导骶丛及股神经阻滞,观察至术后24 h。比较两组血流动力学指标、阻滞完成时间、阻滞起效时间及持续时间、镇痛效果。结果两组阻滞前(T0)、阻滞后10 min(T1)、阻滞后30 min(T2)时心率(HR)、舒张压(DBP)、收缩压(SBP)水平比较,差异无统计学意义(P>0.05);观察组阻滞完成时间(11.68±1.82)min、起效时间(9.14±1.56)min短于对照组,持续时间(256.91±38.74)min长于对照组,差异有统计学意义(t=12.081、9.923、4.385,P<0.05);观察组术后2、12、24 h时视觉模拟评分法(VAS)评分分别为(1.39±0.41)分、(2.37±0.81)分、(2.82±1.06)分,低于对照组,差异有统计学意义(t=2.732、3.225、6.697,P<0.05)。结论在骨科手术中采用超声联合神经刺激仪引导骶丛及股神经阻滞效果确切,对患者血流动力学影响小,起效快、持续时间长,可提升术后镇痛效果,可作为骨科手术中一种更好的麻醉选择。
Objective To analyze the effect of ultrasound combined with nerve stimulator guided sacral plexus and femoral nerve block in orthopedic surgery.Methods A total of 88 patients with orthopedic surgery who were treated in the hospital from Sep⁃tember 2019 to August 2021 were selected and divided into two groups according to the random number table method,with 44 cases in each group.The observation group used ultrasound combined with nerve stimulator to guide sacral plexus and femoral nerve block,while the control group used nerve stimulator to guide sacral plexus and femoral nerve block.Observed until 24 h after operation.The hemodynamic indexes,block completion time,block onset time and duration,and analgesic effect were compared between the two groups.Results There was no statistically significant difference in the levels of heart rate(HR),dia⁃stolic blood pressure(DBP),and systolic blood pressure(SBP)before blockade(T0),10 min after blockade(T1),and 30 min af⁃ter blockade(T2)between the two groups(P>0.05);the completion time of block(11.68±1.82)min and the onset time(9.14±1.56)min of the observation group were shorter than those of the control group,and the duration(256.91±38.74)min was longer than that of the control group,and the difference was statistically significant(t=12.081,9.923,4.385,P<0.05);the visual ana⁃logue scale(VAS)scores in the observation group at 2 h,12 h,and 24 h after operation were(1.39±0.41)points,(2.37±0.81)points,(2.82±1.06)points,which were lower than those in the control group,and the difference was statistically significant(t=2.732,3.225,6.697,P<0.05).Conclusion The use of ultrasound combined with nerve stimulator to guide the sacral plexus and femoral nerve block in orthopedic surgery is effective,has little impact on the patient's hemodynamics,has a fast onset and long duration,can improve postoperative analgesia,and can be used as a better option for anesthesia choice for an orthopaedic surgery.
作者
张艳婕
ZHANG Yanjie(Department of Anesthesiology,Mentougou District Hospital,Beijing,102300 China)
出处
《世界复合医学》
2022年第4期90-93,共4页
World Journal of Complex Medicine
