超声引导下对老年人下肢手术行神经阻滞麻醉的临床应用研究探讨  

Clinical Application of Nerve block Anesthesia Under Ultrasound Guidance in Elderly Patients Undergoing Lower Limb Surgery

作　　者：孙岸灵[1] 谢秋媚 朱俊杰 罗德兴[1] SUN Anling;XIE Qiumei;ZHU Junjie;LUO Dexing(Huizhou Central People’s Hospital,Huizhou 516001,China;不详)

机构地区：[1]广东省惠州市中心人民医院,广东惠州516001

出　　处：《中国医学创新》2020年第25期71-74,共4页Medical Innovation of China

基　　金：惠州市科技计划项目(180530111741990)。

摘　　要：目的:探讨超声引导下对老年人下肢手术行神经阻滞麻醉的应用效果。方法:选取2018年5月-2019年10月于本院行下肢手术的80例老年患者的临床资料进行回顾性分析,按麻醉方法不同将其分为观察组(n=43)和对照组(n=37)。观察组给予超声引导下对相应区域的下肢神经阻滞麻醉,对照组给予腰硬联合麻醉。比较两组麻醉完成、麻醉起效及术后镇痛维持时间。比较两组麻醉前(T0)、麻醉诱导后即刻(T1)、麻醉诱导后30 min(T2)、麻醉诱导后60 min(T3)的平均动脉压(MAP)与心率(HR),比较两组术后各时间点安静时和活动时的镇痛效果。结果:观察组麻醉完成与麻醉起效时间均短于对照组,而术后镇痛维持时间长于对照组(P<0.05)。T1~T3时,对照组MAP均高于观察组(P<0.05);T1时,对照组HR高于观察组(P<0.05)。观察组麻醉不同时间点MAP与HR比较,差异均无统计学意义(P>0.05),而对照组麻醉不同时间点的MAP比较,差异均有统计学意义(P<0.05)。术后6 h,观察组活动时视觉模拟评分法(visual analogue score,VAS)评分低于对照组(P<0.05)。术后12、24、36、48 h,观察组安静与活动时VAS评分均低于对照组(P<0.05)。结论:超声引导下神经阻滞在老年患者下肢手术中麻醉效果较好,术中患者血流动力学较稳定,术后镇痛效果好,值得临床应用。Objective:To investigate the application effect of nerve block anesthesia under ultrasound guidance in elderly patients underwent lower limb surgery.Method:The clinical data of 80 elderly patients underwent lower limb surgery in our hospital from May 2018 to October 2019 were retrospectively analyzed.They were divided into observation group(n=43)and control group(n=37)according to different anesthesia methods.The observation group was given the lower limb nerve block anesthesia under the guidance of ultrasound,and the control group was given combined spinal and epidural anesthesia.The completion of anesthesia,onset of anesthesia and maintenance postoperative analgesia time were compared between the two groups.Mean arterial pressure(MAP)and heart rate(HR)before anesthesia(T0),immediately after anesthesia induction(T1),30 min after anesthesia induction(T2),60 min after anesthesia induction(T3)were compared between the two groups.The analgesic effect of quietness and activity were compared between the two groups at the all postoperative time points.Result:The anesthesia completion time and the onset time of anesthesia in the observation group were lower than those in the control group,while the postoperative analgesia maintenance time in the observation group was higher than that in the control group(P<0.05).At T1-T3,MAP in the control group were higher than those in the observation group(P<0.05).At T1,HR in the control group was higher than that in the observation group(P<0.05).There were no statistically significant differences in MAP and HR at different time points of anesthesia in the observation group(P>0.05).While there were statistically significant differences in MAP at different time points of anesthesia in the control group(P<0.05).At 6 h after surgery,the visual analogue score(VAS)score of activity in the observation group was lower than that of the control group(P<0.05).At 12,24,36 and 48 h after surgery,the VAS scores of quietness and activity in the observation group were lower than those of the contro

关 键 词：超声 下肢手术 神经阻滞 腰硬联合麻醉 

分 类 号：R614[医药卫生—麻醉学]