复合麻醉与局部麻醉在足踝手术中的应用效果对比  

Comparison of application effect between compound anaesthesia and local anaesthesia in ankle surgery

作　　者：李达 卢建新[1] 李慧 LI Da;LU Jian-xin;LI Hui(Department of Ankle Surgery, Central Hospital Affiliated to Shenyang Medical College, Liaoning Province, Shenyang 110024, China)

机构地区：[1]沈阳医学院附属中心医院足踝外科,辽宁沈阳110024

出　　处：《中国当代医药》2019年第9期108-111,共4页China Modern Medicine

摘　　要：目的比较局部麻醉与复合麻醉在足踝手术中的应用效果。方法选取2016年10月～2018年10月我院收治的230例足踝手术患者作为研究对象,根据麻醉方式的不同分为复合组与局麻组,每组各115例。复合组给予复合麻醉,局麻组给予局部麻醉,比较两组患者的麻醉效果。结果复合组的麻醉优良率高于局麻组,差异有统计学意义(P<0.05);复合组患者麻醉后5、15、30 min的心率、收缩压低于局麻组,而舒张压高于局麻组,差异有统计学意义(P<0.05);复合组患者尿潴留、穿刺部位疼痛、术后睡眠欠佳、心动过缓的发生率明显低于局麻组,而恶心呕吐的发生率高于局麻组,术后疼痛评分低于局麻组,差异均有统计学意义(P<0.05);复合组的感觉神经阻滞维持时间、运动神经功阻滞维持时间长于局麻组,差异有统计学意义(P<0.05);两组的感觉神经阻滞起效时间、运动神经阻滞起效时间、麻醉前心率、收缩压和舒张压比较,差异均无统计学意义(P>0.05)。结论在实施足踝手术的过程中进行复合麻醉,可以提高患者的术后镇痛效果,有效地延长了术后镇痛的时间,在一定程度上保证了患者术中心率、收缩压以及舒张压的稳定性,具有比局部麻醉更为理想的麻醉效果,值得临床推广运用。Objective To compare the application effect between compound anaesthesia and local anaesthesia in ankle surgery. Methods A total of 230 cases of ankle surgery patients treated in our hospital from October 2016 to October 2018 were selected as the research objects. According to different anesthesia methods, they were divided into the composite group and the local anesthesia group, with 115 cases in each group. The composite group was given compound anesthesia, and the local anesthesia group was given local anesthesia. The anesthetic effect was compared between the two groups. Results The excellent and good rate of anesthesia in the composite group was higher than that in the local anesthesia group, and the difference was statistically significant (P<0.05). The heart rate and SBP of patients in the composite group were lower than those in the local anesthesia group 5, 15 and 30 minutes after anesthesia, while DBP was higher than those in the local anesthesia group, the difference was statistically significant (P<0.05). The incidences of urinary retention, pain at the puncture site, poor postoperative sleep, and bradycardia in the composite group were significantly lower than those in the local anesthesia group, while the incidence of nausea and vomiting was higher than that in the local anesthesia group, and the postoperative pain score was lower than that in the local anesthesia group, with statistically significant differences (P<0.05). The duration of sensory nerve block and motor nerve work block in the composite group were longer than those in the local anesthesia group, and the differences were statistically significant (P<0.05). There were no statistically significant differences between the two groups in sensory nerve block, motor nerve block onset time, preanesthesia heart rate, systolic blood pressure and diastolic blood pressure (P>0.05). Conclusion In the process of implementation of the foot and ankle surgery compound anesthesia can improve the patients' postoperative analgesia effect, effectively prol

关 键 词：局部麻醉 复合麻醉 足踝手术 运动神经阻滞维持时间 感觉神经阻滞维持时间 

分 类 号：R614[医药卫生—麻醉学]