超声引导对神经阻滞复合全身麻醉在46例胫骨骨折手术中麻醉效果及术后疼痛的影响  

Effect of ultrasound-guided nerve block combined with general anesthesia on anesthesia effect and postoperative pain in 46 cases of tibial fracture surgery

作　　者：刘玉杰[1] 黄海[1] 刘玲[1] 宋景芳[1] LIU Yujie;HUANG Hai;LIU Ling;SONG Jingfang(Department of Anesthesiology,the Second Hospital affiliated to Tianjin University of Traditional Chinese Medicine,Tianjin 300150,China)

机构地区：[1]天津中医药大学第二附属医院麻醉科,天津300150

出　　处：《上海医药》2020年第17期22-24,64,共4页Shanghai Medical & Pharmaceutical Journal

摘　　要：目的 :研究超声引导对神经阻滞复合全身麻醉在胫骨骨折手术中麻醉效果及术后疼痛的影响。方法 :选取胫骨骨折患者92例随机分为对照组和观察组各46例。对照组患者行静脉全身麻醉,观察组患者在此基础上行超声引导下股神经及坐骨神经阻滞复合全身麻醉。比较两组患者拔管时间、苏醒时间、术中瑞芬太尼使用量,术前、术后疼痛视觉模拟评分(VAS),术后PCIA按压次数、剩余药量及不良反应发生情况。结果 :观察组患者的拔管时间、苏醒时间显著短于对照组短(P <0.05),瑞芬太尼使用量显著少于对照组(P <0.01)。术后观察组患者VAS评分和不良反应发生率显著低于对照组、患者PCIA按压次数显著少于对照组,剩余药量显著多于对照组(P <0.01)。结论 :超声引导神经阻滞复合全身麻醉在胫骨骨折手术中麻醉效果确切,镇痛维持时间长、麻醉不良反应少。Objective:To study the effect of ultrasound-guided nerve block combined with general anesthesia on anesthesia effect and postoperative pain in tibial fracture surgery.Methods:Ninety-two patients with tibial fracture were randomly divided into a control group and an observation group with 46 cases each.The control group underwent intravenous general anesthesia while the observation group underwent ultrasound-guided femoral nerve and sciatic nerve block combined with general anesthesia.The extubation time,awakening time,intraoperative remifentanil dose,preoperative and postoperative visual analogue scale(VAS),postoperative PCIA compression times,residual drug dose and the incidence of adverse reactions were compared between the two groups.Results:The extubation time and awakening time were significantly shorter and the remifentanil dose was significantly less in the observation group than the control group(P<0.05).After operation,the score of VAS,and the incidence of adverse reactions were significantly lower,the times of PCIA compression was significantly less and the amount of residual drug was significantly higher in the observation group than the control group(P<0.05).Conclusion:Ultrasound guided nerve block combined with general anesthesia in tibial fracture surgery has definite anesthetic effect,long duration of analgesia and less adverse reactions.

关 键 词：超声引导 神经阻滞 全身麻醉 胫骨骨折 术后疼痛 

分 类 号：R614.4[医药卫生—麻醉学] R683.42[医药卫生—外科学]