股神经阻滞联合单侧蛛网膜下腔阻滞麻醉在股骨骨折手术中的临床应用  

Clinical Application of Femoral Nerve Block Combined with Unilateral Spinal Anesthesia in Femoral Fracture Surgery

作　　者：梁锋 LIANG Feng(Shanghai Oriental Hospital Group Suqian Oriental Hospital,Suqian 223800,China)

机构地区：[1]上海东方医院集团宿迁市东方医院,江苏宿迁223800

出　　处：《吉林医学》2021年第11期2634-2636,共3页Jilin Medical Journal

摘　　要：目的:通过临床观察股骨骨折手术,评估股神经阻滞联合单侧蛛网膜下腔阻滞麻醉在股骨骨折手术中的镇痛效果及临床应用优势。方法:选取2015年1月~2020年1月股骨骨折患者60例,随机分为观察组(n=30)和对照组(n=30)。对照组给予腰-硬联合麻醉,观察组给予股神经阻滞联合单侧蛛网膜下腔阻滞麻醉,以T_(0)、T_(1)、T_(2),心率、血压及两组不良反应为评价指标。结果:两组患者在麻醉操作时间(T_(0))方面,差异无统计学意义(P>0.05);观察组痛觉阻滞起效时间(T1)及痛觉阻滞持续时间(T_(2))均较对照组时间长,差异具有统计学意义(P<0.05)。两组心率比较注药后各时间点与麻醉前相比,无明显变化,差异无统计学意义(P>0.05);观察组血压值注药后各时间点与麻醉前相比,无明显变化,差异无统计学意义(P>0.05);对照组血压值注药后各时间点与麻醉前相比,有明显变化,差异具有统计学意义(P<0.05);观察组血压值注药后各时间点与对照组相比,差异均具有统计学意义(P<0.05)。观察组不良反应率为6.67%,低于对照组的20.00%,差异具有统计学意义(P<0.05)。结论:股神经阻滞联合单侧蛛网膜下腔阻滞麻醉能满足股骨骨折的手术需要,麻醉疗效好,血流动力学稳定,不良反应发生少,值得进行推广及使用。Objective To evaluate the analgesic effect and clinical application advantages of femoral nerve block and unilateral spinal anesthesia in femoral fracture surgery by clinical observation.Method 60 patients with femoral fracture in our hospital from January 2015 to January 2020 were randomly divided into observation group(30 cases)and control group(30 cases).The control group was given combined spinal epidural anesthesia,while the observation group was given femoral nerve block and unilateral spinal anesthesia.T_(0),T_(1),T_(2),heart rate,blood pressure and adverse reactions of the two groups were used as evaluation indexes.Results There was no significant difference in anesthesia operation time(T_(0))between the two groups(P>0.05);the onset time of pain block(T_(1))and the duration of pain block(T_(2))in the observation group were longer than those in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in heart rate between the two groups at each time point after injection and before anesthesia(P>0.05);the blood pressure value of the observation group had no significant change compared with that before anesthesia(P>0.05);the blood pressure value of the control group had significant changes after injection compared with that before anesthesia,and the difference was statistically significant(P<0.05);There were statistically significant differences in blood pressure between the observation group and the control group at each time point(P<0.05).The adverse reaction rate of the observation group was 6.67%,which was lower than 20.00%of the control group,the difference was statistically significant(P<0.05).Conclusion Femoral nerve block combined with unilateral spinal anesthesia can meet the needs of femoral fracture surgery,with good anesthetic effect,stable hemodynamics and less adverse reactions,which is worthy of promotion and use.

关 键 词：股神经阻滞 蛛网膜下腔阻滞麻醉 腰-硬联合麻醉 股骨骨折 麻醉 

分 类 号：R614[医药卫生—麻醉学]