摘要
目的 分析老年髋关节置换术患者行超声引导下腰骶丛神经阻滞(UGLPB)联合全身麻醉的效果。方法 选择2019年2月至2021年1月在南充市中心医院行髋关节置换术的老年高龄患者84例进行研究,随机分为两组,各42例。对照组行全身麻醉,观察组在此基础上加以UGLPB。比较两组患者应激反应指标、血流动力学参数、脑损伤指标及不良反应。结果 观察组舒芬太尼用量[(15.03±4.18)ml vs(31.95±7.82)ml]少于对照组,观察组术后拔管时间[(17.11±1.82)min vs(14.29±2.85)min]及排气时间[(13.54±2.63)h vs(21.06±3.57)h]均短于对照组(P<0.01)。术后两组患者血糖、C反应蛋白水平均高于术前,但观察组均低于对照组(P<0.01)。两组患者平均动脉压、心率比较差异有统计学意义(P<0.01)。术后两组患者S100β、神经元特异性烯醇化酶(NSE)水平均高于术前,但观察组均低于对照组(P<0.01)。对照组围术期共出现不良反应3例(7.14%),观察组2例(4.76%),差异无统计学意义(P>0.05)。结论 UGLPB联合全身麻醉较单独使用全身麻醉可减少高龄髋关节置换术患者舒芬太尼用量,缩短拔管时间及排气时间,减小患者血流动力学参数、应激指标及脑损伤指标的波动,安全性较好。
Objective To exlpore the effect of ultrasound-guided lumbosacral plexus block(UGLPB) combined with general anesthesia in elderly patients with hip arthroplasty. Methods A total of 84 elderly patients who underwent hip arthroplasty in Nanchong Central Hospital from February 2019 to January 2021 were selected and divided into control group(n=42, with general anesthesia) and observation group(n=42, with UGLPB and general anesthesia) randomly. The general operation conditions, stress reaction indexes, hemodynamic parameters, brain injury indexes and adverse reactions were compared between two groups. Results In observation group, the dosage of sufentanil was significantly less than that in control group [(15.03±4.18)ml vs(31.95±7.82)ml], and the postoperative extubation time [(17.11±1.82)min vs(14.29±2.85)min] and exhaust time [(13.54±2.63)h vs(21.06±3.57)h] were shorter than those in control group(P<0.01). The levels of blood glucose and C-reactive protein after operation were significantly higher than those before operation in two groups, however, they were statistically lower in observation group than those in control group(P<0.01). There were significant differences in mean arterial pressure and heart rate between two groups(P<0.01). After operation, the levels of S100 β and neuron-specific enolase(NSE) were significantly higher than those before operation in two groups, but they were lower in observation group than those in control group(P<0.01). There were 3 cases(7.14%) showing adverse reactions in control group and 2 cases(4.76%) in observation group, without significant difference in it(P>0.05). Conclusion Compared with general anesthesia alone, UGLPB combined with general anesthesia can reduce the dosage of sufentanil and the fluctuation of hemodynamic parameters, stress reaction indexes and brain injury indexes and shorten the extubation time and exhaust time with good safety in elderly patients receving hip arthroplasty.
作者
冯兴龙
张小欣
赵星
杜宇
FENG Xing-long;ZHANG Xiao-xin;ZHAO Xing;DU Yu(Department of Anesthesiology,The Second Clinical Medical College of North Sichuan Medical College(Nanchong Central Hospital),Nanchong,Sichuan 637000,China)
出处
《中国临床研究》
CAS
2022年第6期810-813,818,共5页
Chinese Journal of Clinical Research
基金
四川省基层卫生事业发展研究中心资助项目(SWF21-Y-42)。
