刍议喉罩全麻联合B超引导下股神经及坐骨神经阻滞在老年患者下肢手术中的应用价值  

Discussion on the Application Value of Laryngeal Mask General Anesthesia Combined with Ultrasound-guided Femoral Nerve and Sciatic Nerve Block in Lower Limb Surgery in Elderly Patients

作　　者：黄威[1] HUANG Wei(Department of Anesthesiology,Fuzhou Second Hospital,Fuzhou,Fujian Province,350000 China)

机构地区：[1]福州市第二医院麻醉科,福建福州350000

出　　处：《中外医疗》2021年第6期23-25,共3页China & Foreign Medical Treatment

摘　　要：目的分析喉罩全麻联合B超引导下股神经及坐骨神经阻滞在老年患者下肢手术中的应用价值。方法方便选择该院2017年1月—2019年12月接收治疗的92例行下肢手术的老年患者作为该次研究的对象,以数字随机法将其分作两组,各组46例。其中,甲组患者单独给予喉罩全麻办法,乙组患者采取喉罩全麻联合B超引导下股神经及坐骨神经阻滞办法,比较两组患者不同方式下的临床应用效果。结果乙组患者在切皮时和拔喉罩时的HR和MAP显著低于甲组,差异有统计学意义(P<0.001);乙组患者苏醒时间(5.46±1.17)min较甲组(11.35±2.56)min早,差异有统计学意义(t=14.193,P<0.001);瑞芬太尼用量(32.53±8.27)μg低于甲组(68.27±9.38)μg,差异有统计学意义(t=19.384,P<0.001);术后疼痛评分(3.14±0.51)分低于甲组(7.23±1.24)分,差异有统计学意义(t=20.689,P<0.001)。结论针对行下肢手术的老年患者采取喉罩全麻联合B超引导下股神经及坐骨神经阻滞能够提高手术的安全性,减少手术过程中全麻的用药量,维持循环系统的稳定,还能加快患者术后苏醒的时间,降低术后疼痛,减少不良反应,该方法值得临床上推广及应用。Objective To analyze the application value of laryngeal mask general anesthesia combined with ultrasound-guided femoral nerve and sciatic nerve block in lower limb surgery in elderly patients.Methods 92 elderly patients undergoing lower extremity surgery who were treated in the hospital from January 2017 to December 2019 were convenient selected as the subjects of this study,and they were divided into two groups by numerical randomization,with 46 cases in each group.Among them,patients in group A were given laryngeal mask general anesthesia alone,and patients in group B were given laryngeal mask general anesthesia combined with ultrasound-guided femoral nerve and sciatic nerve block methods to compare the clinical effects of the two groups of patients under different methods.Results The HR and MAP of patients in group B were significantly lower than those in group A,the difference was statistically significant(P<0.001);during skin incision and laryngeal mask removal;patients in group B had a better recovery time(5.46±1.17)min than those in group A(11.35±2.56)min,the difference was statistically significant(t=14.193,P<0.001);the dosage of remifentanil(32.53±8.27)μg was lower than that of group A(68.27±9.38)μg,the difference was statistically significant(t=19.384,P<0.001);the postoperative pain score(3.14±0.51)points was lower than that of group A(7.23±1.24)points,the difference was statistically significant(t=20.689,P<0.001).Conclusion For elderly patients undergoing lower extremity surgery,general anesthesia with laryngeal mask combined with B-guided femoral nerve and sciatic nerve block can improve the safety of surgery,reduce the amount of general anesthesia used during surgery,and maintain the stability of the circulatory system.To speed up the time for patients to wake up after surgery,reduce postoperative pain,and reduce adverse reactions.This method is worthy of clinical promotion and application.

关 键 词：喉罩全麻 B超 股神经 坐骨神经 老年患者 下肢手术 应用 

分 类 号：R5[医药卫生—内科学]