摘要
目的 探讨超声引导下坐骨神经联合股神经阻滞麻醉在老年胫骨骨折患者手术中的应用效果。方法选取2019年3月至2020年3月禹州市人民医院收治的150例老年胫骨骨折患者作为研究对象,并按照不同麻醉方式将其分为观察组(75例)与对照组(75例),观察组患者采用超声引导下坐骨神经联合股神经阻滞麻醉,对照组患者采用腰硬联合麻醉,对比观察两组患者感觉与运动神经阻滞起效时间、阻滞维持时间以及术后2、8、24、48 h视觉模拟评分法(VAS)评分与不良反应发生情况。结果 观察组患者感觉与运动神经阻滞起效时间均明显短于对照组(t=8.227、8.976,P均<0.001)、阻滞维持时间均明显长于对照组(t=14.216、17.117,P均<0.001);术后2、8、24、48 h,观察组患者VAS评分均明显低于对照组(t=10.967、9.312、16.827、11.687,P均<0.001);术后,观察组患者不良反应发生率为4.00%,明显低于对照组患者的不良反应发生率14.67%(χ^(2)=5.042,P=0.025)。结论 与腰硬联合麻醉相比,超声引导下坐骨神经联合股神经阻滞更有利于提高老年胫骨骨折患者的术中麻醉效果,减轻术后疼痛程度,安全性更好,临床应用价值更高。
Objective To investigate the effect of applying ultrasound-guided sciatic nerve and femoral nerve block in the operation of elderly patients with tibial fracture.Methods 150 elderly patients with tibial fracture,admitted into Yuzhou People’s Hospital between March 2019 and March 2020,were enrolled as research subjects and divided into observation group(n=75) and control group(n=75) based on different anesthesia methods they received.Patients received ultrasound-guided sciatic nerve and femoral nerve block in observation group,while patients in control group underwent combined spinal-epidural anesthesia.Onset time and duration of sensory and motor nerve block,visual analogue scale(VAS) scores at 2 h,8 h,24 h and 48 h after surgery,and occurrence of adverse reactions were compared between the two groups.Results The onset times of sensory and motor nerve block in patients in observation group was obviously shorter than control group(t=8.227 and 8.976,both P <0.001),and the durations of block were markedly longer(t=14.216 and 17.117,both P <0.001).Compared with control group,the VAS scores of patients in observation group were markedly lower respectively at 2 h,8 h,24 h and 48 h after surgery(t=10.967,9.312,16.827 and 11.687,all P <0.001),and after surgery the incidence of adverse reaction was 4.00%,being much lower than 14.67% in control group(χ^(2)=5.042,P=0.025).Conclusion Compared with combined spinal-epidural anesthesia,the ultrasound-guided sciatic nerve and femoral nerve block is more beneficial for good anesthetic effect for elderly patients when undergoing operation for tibial fracture,and ameliorate their postoperative pain,and is safe to operate,presenting much high value of clinical application.
作者
尹全伟
陈凤伟
赵会奇
任海峰
王聪丽
YIN Quanwei;CHEN Fengwei;ZHAO Huiqi;REN Haifeng;WANG Congli(Department of Anesthesia,Yuzhou People’s Hospital,Xuchang,Henan 461000,China)
出处
《中国烧伤创疡杂志》
2022年第5期361-364,共4页
The Chinese Journal of Burns Wounds & Surface Ulcers
关键词
胫骨骨折
超声引导
坐骨神经阻滞
股神经阻滞
麻醉
疼痛
Tibial fracture
Ultrasound guidance
Sciatic nerve block
Femoral nerve block
Anesthesia
Pain
