摘要
目的探讨B超引导下髂筋膜间隙-骶丛神经阻滞结合右美托咪定持续泵注在老年髋部骨折手术中的应用效果。方法选择2020年1月至2021年1月于我院确诊并行手术治疗的40例老年髋部骨折患者作为研究对象,根据麻醉方式不同将其分为对照组和研究组,各20例。对照组采用全身麻醉联合右美托咪定持续泵注,研究组采用B超引导下髂筋膜间隙-骶丛神经阻滞结合右美托咪定持续泵注。比较两组的麻醉效果。结果研究组麻醉后30 min的Richmond躁动镇静评分量表(RASS)评分低于对照组,差异具有统计学意义(P<0.05)。研究组的感觉阻滞起效时间、运动阻滞起效时间、感觉阻滞完善时间、运动阻滞完善时间短于对照组,差异具有统计学意义(P<0.05)。研究组的苏醒时间、意识恢复时间、机械通气时间及术后拔管时间短于对照组,差异具有统计学意义(P<0.05)。苏醒后,两组的皮质醇(Cor)、肾上腺素(ADR)及血糖水平均升高,但研究组低于对照组,差异具有统计学意义(P<0.05)。术后2、6、12 h,研究组的简易精神状态量表(MMSE)评分高于对照组,差异具有统计学意义(P<0.05)。结论老年髋部骨折手术中应用B超引导下髂筋膜间隙-骶丛神经阻滞结合右美托咪定持续泵注能提高麻醉效果,改善苏醒质量及认知功能,减轻应激反应,适用于老年群体,值得推广应用。
Objective To explore the application effect of B-ultrasound guided fascia iliaca compartment-sacral plexus block combined with continuous pumping of dexmedetomidine in elderly hip fracture surgery.Methods A total of 40 elderly patients with hip fracture diagnosed and treated with surgery in our hospital from January 2020 to January 2021 were selected as the research objects.According to different anesthesia methods,the patients were divided into control group and study group,with 20 cases in each group.The control group was treated with general anesthesia combined with continuous pumping of dexmedetomidine,and the study group was treated with B-ultrasound guided fascia iliaca compartment-sacral plexus block combined with continuous pumping of dexmedetomidine.The anesthetic effects of the two groups were compared.Results The Richmond Agitation Sedation Scale(RASS)score at 30 min after anesthesia in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).The onset time of sensory block,the onset time of motor block,the perfect time of sensory block,the perfect time of motor block in the study group were shorter than those in the control group,and the differences were statistically significant(P<0.05).The recovery time,consciousness recovery time,mechanical ventilation time and postoperative extubation time of the study group were shorter than those of the control group,and the differences were statistically significant(P<0.05).After awakening,the levels of cortisol(Cor),adrenaline(ADR)and blood glucose in the two groups increased,but those in the study group were lower than the control group,the differences were statistically significant(P<0.05).At 2,6 and 12 h after operation,the Mini-Mental State Examination(MMSE)score of the study group was higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusion The B-ultrasound guided fascia iliaca compartment-sacral plexus block combined with continuous pumping of dexmed
作者
高琼
马丹
GAO Qiong;MA Dan(Traditional Chinese Medicine Hospital of Yulin,Yulin 719000,China)
出处
《临床医学研究与实践》
2023年第13期74-77,共4页
Clinical Research and Practice
关键词
髋部骨折
B超引导下髂筋膜间隙-骶丛神经阻滞
右美托咪定
应激反应
苏醒质量
hip fracture
B-ultrasound guided fascia iliaca compartment-sacral plexus block
dexmedetomidine
stress response
quality of recovery
