超声引导下穿刺定位行腰丛-坐骨神经阻滞麻醉在高龄人工膝关节置换术中的应用效果  

Application Effect of Lumbar Plexus-sciatic Nerve Block Anesthesia under Ultrasound-guided Puncture Location in Artificial Knee Replacement in the Elderly

作　　者：范宇飞 FAN Yufei(Kazuo County Central Hospital,Chaoyang 122300,China)

机构地区：[1]朝阳市喀左县中心医院,辽宁朝阳122300

出　　处：《中国医药指南》2021年第10期84-85,共2页Guide of China Medicine

摘　　要：目的探讨高龄人工膝关节置换术中超声引导下穿刺定位行腰丛-坐骨神经阻滞麻醉的效果。方法选取2018年4月至2019年4月我院接收并行人工膝关节置换术的50例高龄患者,根据麻醉方法的不同将其分为对照组(24例)和研究组(26例)。对照组采用硬膜外麻醉,研究组采用超声引导下穿刺定位行腰丛-坐骨神经阻滞麻醉,对比两组的麻醉效果。结果研究组麻醉起效时间、维持时间均短于对照组(P<0.05)。两组术中出血量对比,差异无统计学意义(P>0.05);研究组术中补液量、术后引流量均少于对照组,早期进食时间短于对照组(P<0.05)。在T0时,两组各血流动力学指标对比,差异无统计学意义(P>0.05);在T_(1)、T2、T3时,研究组SpO2高于对照组(P<0.05);在T_(1)、T2、T3时,两组HR对比,差异有统计学意义(P<0.05);在T_(1)、T2时,研究组MAP高于对照组(P<0.05);但在T3时,两组MAP对比,差异无统计学意义(P>0.05)。结论高龄人工膝关节置换术中超声引导下穿刺定位行腰丛-坐骨神经阻滞麻醉的效果显著。Objective To study the ultrasound-guided puncture and localization of lumbar plexus-sciatic nerve block anesthesia during artificial knee arthroplasty in the elderly.Methods From April 2018 to April 2019,50 elderly patients who received concurrent artificial knee replacement surgery in our hospital were selected,and they were divided into a control group(24 cases)and a study group(26 cases)according to different anesthesia methods.The control group used epidural anesthesia,and the study group used ultrasound-guided puncture to perform lumbar plexus-sciatic nerve block anesthesia.The anesthesia effects of the two groups were compared.Results The onset time and maintenance time of anesthesia in the study group were shorter than those in the control group(P<0.05).There was no significant difference in intraoperative blood loss between the two groups(P>0.05);the intraoperative fluid supplement and postoperative drainage volume of the study group were less than those of the control group,and the early eating time was shorter than that of the control group(P<0.05).At T0,there was no statistically significant difference in the hemodynamic indexes between the two groups(P>0.05);at T_(1),T_(2),and T_(3),the SpO2 of the study group was higher than that of the control group(P<0.05);at T_(1),T_(2) T_(3),the difference in HR between the two groups was statistically significant(P<0.05);at T_(1) and T_(2),the MAP of the study group was higher than that of the control group(P<0.05);but at T_(3),the MAP of the two groups was no statistical significance(P>0.05).Conclusion Ultrasound-guided puncture and positioning of lumbar plexus-sciatic nerve block anesthesia during artificial knee arthroplasty in elderly patients is effective and can be generalized.

关 键 词：人工膝关节置换术 超声 穿刺定位 麻醉效果 

分 类 号：R687.4[医药卫生—骨科学]