超声引导下神经阻滞麻醉在老年患者单下肢骨科手术中应用及对其疼痛评分的影响观察  

Application of ultrasound-guided nerve block anesthesia in elderly patients with lower extremity orthopedic surgery and its effect on pain score

作　　者：王旭莉[1] 郭志华[1] WANG Xuli;GUO Zhihua(Department of Anesthesiology,The First Hospital of Fangshan District, Beijing 102400,China)

机构地区：[1]北京市房山区第一医院麻醉科

出　　处：《临床合理用药杂志》2019年第19期31-32,共2页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察超声引导下神经阻滞麻醉在老年患者单下肢骨科手术中应用及对其疼痛评分的影响.方法回顾性分析2017年8月-2018年8月在医院进行单下肢骨科手术的老年患者58例,随机分为观察组和对照组各29例,观察组在术中接受超声引导下神经阻滞麻醉,对照组在术中接受腰硬联合麻醉.对比2组患者在术中的麻醉效果、疼痛情况及不良反应发生情况.结果观察组患者的麻醉总有效率为100.00%高于对照组的72.41%,差异有统计学意义(χ^2=9.280,P<0.05).观察组患者的感觉阻滞起效时间、运动阻滞起效时间、运动阻滞维持时间及术后镇痛持续时间均长于对照组,差异均有统计学意义(P<0.05).术后12 h观察组患者的并发症发生率为3.45%低于对照组的51.72%,差异有统计学意义(χ^2=16.917,P<0.05).结论临床对单下肢骨科手术老年患者应用超声引导下神经阻滞麻醉可有效延长阻滞时间、延长术后镇痛持续时间,降低麻醉并发症的发生率,提升手术效果,故方案值得推广.Objective To investigate the application of ultrasound-guided nerve block anesthesia in orthopaedic sur- gery of single lower limb in elderly patients and its effect on pain score. Methods A retrospective analysis was made on 58 elderly patients who underwent orthopaedic surgery of one lower limb in the hospital from August 2017 to August 2018. They were randomly divided into observation group and control group,29 patients in each group. The observation group received ul- trasound-guided nerve block anesthesia during operation and the control group received combined spinal - epidural anesthesia during operation. The anesthetic effect,pain and adverse reactions of two groups were compared. Results The total effective rate of anesthesia in bservation group was 100. 00% higher than 72. 41% in control group,and the difference was statistically significant(χ2 = 9. 280,P < 0. 05). The onset time of sensory block,the onset time of exercise block,the duration of exercise block and the duration of postoperative analgesia were longer in observation group than control group,and the difference was statistically significant( P < 0. 05). The complication rate was 3. 45% in observation group and 51. 72% in control group at 12 hours after operation,the difference was statistically significant(χ2 = 16. 917,P < 0. 05). Conclusion Ultrasound-guided nerve block anesthesia can effectively improve the time of obstruction,prolong the duration of postoperative analgesia,reduce the incidence of complications of anesthesia and improve the effect of operation for elderly patients undergoing orthopaedic sur- gery of one lower limb.

关 键 词：超声引导 神经阻滞麻醉 老年 单下肢骨科手术 

分 类 号：R614[医药卫生—麻醉学]