超声引导下肢神经阻滞复合右美托咪定持续泵注在老年重危患者髋关节置换术中的应用  

Application of Ultrasound-guided Lower Extremity Nerve Block Combined with Dexmedetomidine Continuous Pump Injection in Hip Replacement of Elderly Critically Ill Patients

作　　者：梁鹏 刘庆仁 蒋倩敏 LIANG Peng;LIU Qing-ren;JIANG Qian-min(Operating Room,6th Floor,Inpatient Department,Dongguan City the Eighth People's Hospital of Guangdong,Dongguan,Guangdong,523320)

机构地区：[1]广东省东莞市第八人民医院住院部6楼手术室,广东东莞523320

出　　处：《智慧健康》2020年第15期138-139,共2页Smart Healthcare

摘　　要：目的探究老年危重症患者行髋关节置换术期间应用超声引导下肢神经阻滞复合右美托咪定持续泵注的麻醉效果。方法选取2016年7月至2018年6月我院行单侧人工髋关节置换术治疗的老年危重症患者80例入组,随机自愿原则下分为两组,每组各40例,对照组实施静脉泵注射右美托咪定复合全身麻醉,术后给予持续静脉镇痛48 h;观察组实施超声引导下肢神经阻滞复合右美托咪定持续泵注,术后给予持续静脉镇痛48 h。结果术后2 h与12 h时的VAS评分比较,观察组低于对照组(P<0.05);术后自控右美托咪定给药剂量比较,观察组低于对照组(P<0.05);两组血流动力学指标比较存在差异(P<0.05)。结论老年危重患者行髋关节置换术时,选用超声引导下肢神经阻滞复合右美托咪定持续泵注进行麻醉,可使血流动力学稳定维持,减轻疼痛感,减少术后镇痛药物给予量,安全性更高,更值得临床推广。Objective To investigate anesthesia effect of ultrasound-guided lower extremity nerve block combined with continuous pumping of dexmedetomidine in hip replacement of elderly critically ill patients.Methods Choose 80 cases elderly critically ill patients with unilateral hip replacement from July 2016 to June,2018,divide them into two groups randomly,40 cases in each group.Control group received intravenous pump injection of dexamethasone tomidine combined with general anesthesia,with postoperative continuous intravenous analgesia for 48 hours;observation group received continuous ultrasound pump-guided lower extremity nerve block combined with dexmedetomidine,with postoperative continuous intravenous analgesia for 48 hours.Results VAS scores at 2h and 12h after operation in observation group were lower than control group(P<0.05);postoperative self-controlled dose of dexmedetomidine was lower than observation group(P<0.05);there were differences in hemodynamic indexes between two groups(P<0.05).Conclusion Ultrasound-guided lower extremity nerve block combined with dexmedetomidine continuous pump injection can maintain hemodynamic stability,reduce pain and postoperative analgesic drugs during hip replacement surgery of elderly critically ill patients,with higher safety,which is worthy of clinical promotion.

关 键 词：超声 下肢神经阻滞 右美托咪定 髋关节置换术 

分 类 号：R614[医药卫生—麻醉学]