摘要
目的探讨老年全髋关节置换术(total hip arthroplasty,THA)患者行髂筋膜间隙阻滞(fascia iliaca compartment block,FICB)对术后谵妄的影响。方法方便选取2021年1—12月期间于菏泽市立医院行THA的老年患者94例为研究对象,按照随机数表法分为研究组与对照组,各47例。对照组在常规全麻下实施THA手术治疗,研究组在全麻诱导前实施FICB麻醉。针对两组不同时间点[手术时(T1)、切皮时(T2)、扩髓时(T3)]的血流动力学[心率(HR)与平均动脉压(MAP)]指标、术后48、72 h时的疼痛视觉模拟评分法(VAS)与谵妄发生率进行观察与对比。结果T2与T3时,研究组的HR与MAP均较对照组低,差异有统计学意义(P<0.05)。研究组术后48、72 h时的VAS评分(3.20±0.30)分、(1.60±0.40)分均低于对照组的(5.46±0.52)分、(3.32±0.28)分,差异有统计学意义(t=25.809、24.150,P<0.05)。研究组术后48、72 h时的谵妄发生率低于对照组,差异有统计学意义(P<0.05)。结论老年THA患者行FICB麻醉能够有效保持血流动力学指标的稳定性,缓解术后疼痛症状,降低谵妄发生率。
Objective To investigate the effect of fascia iliaca compartment block(FICB)on postoperative delirium in elderly patients undergoing total hip arthroplasty(THA).Methods 94 elderly patients who underwent THA at Heze Municipal Hospital from January to December 2021 were conveniently selected as the study subjects.They were divided into a study group and a control group according to the random number table method,with 47 patients in each group.The control group received THA surgery under conventional general anesthesia,while the study group received FICB anesthesia before induction of general anesthesia.Observations and comparisons were made on hemodynamic[heart rate(HR)and mean arterial pressure(MAP)]indicators at two different time points during surgery(T1),skin incision(T2),and pulp expansion(T3),as well as pain Visual Analogue Score(VAS)and delirium incidence at 48 h and 72 h after surgery.Results At T2 and T3,the HR and MAP of the study group were lower than those of the control group,and the difference was statistically significant(P<0.05).The VAS scores(3.20±0.30)points and(1.60±0.40)points of the study group at 48 h and 72 h after surgery were lower than those of the control group(5.46±0.52)points and(3.32±0.28)points,the difference was statistically significant(t=25.809,24.150,P<0.05).The incidence of delirium in the study group at 48 and 72 hours after surgery were lower than those in the control group,the difference was statistically significant(P<0.05).Conclusion FICB anesthesia in elderly THA patients can effectively maintain the stability of hemodynamic indexes,relieve postoperative pain symptoms,and reduce the incidence of delirium.
作者
贾雅蕊
郭继燕
程晓辉
JIA Yarui;GUO Jiyan;CHENG Xiaohui(Department of Anesthesiology,Heze Municipal Hospital,Heze,Shandong Province,274000 China)
出处
《中外医疗》
2023年第14期84-88,共5页
China & Foreign Medical Treatment
关键词
老年
全髋关节置换术
髂筋膜间隙阻滞
谵妄
Elderly
Total hip arthroplasty
Fascia iliaca compartment block
Delirium
