超声引导下肢神经阻滞复合右美托咪定持续泵注应用于老年危重患者髋关节置换术效果观察  

Ultrasound-guided lower limb nerve block combined with continuous pumping of dexmedetomidine for hip replacement in critical elderly patients

作　　者：潘刘生 吴春林[1] 张光旭 张天明[1] PAN Liusheng;WU Chunlin;ZHANG Guangxu;ZHANG Tianming(Xinyi People's Hospital,Xinyi 525300,China)

机构地区：[1]信宜市人民医院,广东信宜525300

出　　处：《包头医学院学报》2020年第12期43-46,83,共5页Journal of Baotou Medical College

摘　　要：目的:探讨分析超声引导下肢神经阻滞复合右美托咪定持续泵注应用于老年危重患者髋关节置换术效果。方法:选取2017年2月~2020年8月74例在本院行髋关节置换术老年危重患者分为实验组和对照组。实验组给予超声引导下肢神经阻滞复合右美托咪定持续泵注麻醉,对照组给予静脉泵注右美托咪定复合全身麻醉,比较两组时间点血流动力学变化、VAS评分、术后镇痛泵按压次数、不良发生情况。结果:T0、T1、T2、T3、T4时间点两组SpO2指标水平无显著性差异(P>0.05),T0时间点两组HR、MAP指标水平无显著性差异(P>0.05),T1、T4时间点实验组HR指标水平较对照组显著降低(P<0.05),T2、T3时间点实验组HR指标水平较对照组显著提高,T1、T2、T3时间点实验组MAP指标水平较对照组显著提高(P<0.05),T4时间点实验组MAP指标水平较对照组显著降低(P<0.05),术后2、4、8、12、24、48 h实验组静息、运动时VAS评分较对照组均显著下降(P<0.05),术后实验组、对照组镇痛泵平均按压次数分别为(4.39±2.01)、(12.14±1.67)次,实验组镇痛泵按压次数较对照组显著减少(P<0.05),实验组不良反应发生率(10.81%)较对照组(29.73%)显著降低(P<0.05)。结论:超声引导下肢神经阻滞复合右美托咪定持续泵注麻醉应用于老年危重髋关节置换术可以有效维持血流动力学稳定,降低并发症发生的风险,并且缓解患者术后疼痛,减少镇痛泵按压次数,进而减少麻醉药物使用剂量,降低不良反应发生率,安全性高,值得推广。Objective:To explore and analyze the effect of ultrasound-guided lower extremity nerve block combined with continuous pumping of dexmedetomidine for hip replacement in the critical elderly.Method:74 cases of critically ill elderly patients undergoing hip arthroplasty in our hospital from February 2017 to August 2020 were selected and divided into experimental group and control group.The experimental group was given ultrasound-guided lower limb nerve block combined with continuous pump of dexmedetomidine anesthesia,and the control group was given intravenous pump dexmedetomidine combined with general anesthesia.The hemodynamic changes,VAS scores,postoperative analgesic pump compression times,and occurrence of adverse events at time points were compared between the two groups.Results:There was no significant difference in SpO2 index level between the two groups at T0,T1,T2,T3,and T4(P>0.05).There was no significant difference in HR and MAP index levels between the two groups at T0(P>0.05).The HR index levels in the experimental group were significantly lower than those in the control group at T1 and T4(P<0.05);the HR index levels of the experimental group at T2 and T3 were significantly higher than those of the control group;the MAP index levels of the experimental group at T1,T2,and T3 were significantly higher than those of the control group(P<0.05),and the MAP index level of the experimental group at T4 time point decreases significantly compared with that in the control group(P<0.05).The VAS scores of the experimental group during resting and exercise at 2,4,8,12,24,48h after the operation were significantly lower than those of the control group(P<0.05).The average numbers of pump compressions were(4.39±2.01)and(12.14±1.67)times respectively in the experimental group and the control group;the number of analgesic pump compressions in the experimental group was significantly less than that in the control group(P<0.05).The incidence of adverse reactions in the experimental group was 10.81%and 29.73 in the contro

关 键 词：超声引导 下肢神经阻滞 右美托咪定 静脉泵注 髋关节置换 危重 

分 类 号：R47[医药卫生—护理学]