腰硬联合麻醉结合髂筋膜阻滞对老年髋关节手术患者神经阻滞效果及认知功能的影响  

Effect of Combined Spinal Epidural Anesthesia Combined with Iliac Fascia Block on Nerve block and Cognitive Function in Elderly Patients Undergoing Hip Surgery

作　　者：徐文娟 王忱 陈亚迟 陈桂清 XU Wenjuan;WANG Chen;CHEN Yachi;CHEN Guiqing(The Second Affiliated Hospital of Xiamen Medical College,Xiamen 361021,China)

机构地区：[1]厦门医学院附属第二医院,福建厦门361021

出　　处：《中国医药指南》2021年第34期52-53,56,共3页Guide of China Medicine

摘　　要：目的分析腰硬联合麻醉结合髂筋膜阻滞对老年髋关节置换手术患者神经阻滞效果及认知功能的影响。方法选择我院2019年1月至2020年1月收治的120例老年髋关节手术患者,按照随机分组的方式,将其分为观察组与对照组,每组60例。对照组进行腰硬联合麻醉,观察组在此基础之上开展复合髂筋膜阻滞麻醉。对比两组患者丙泊酚的使用剂量、疼痛评分以及麻醉诱导期间的不良反应、认知功能评分,采用简易精神状态评估量表(MMSE)评分标准对患者的认知功能进行评价。结果观察组患者丙泊酚使用剂量低于对照组,疼痛评分低于对照组,麻醉诱导期间的不良反应低于对照组,两组之间对比具有显著差异(P <0.05);观察组患者认知功能评分高于对照组,具有显著差异(P <0.05)。结论在腰硬联合麻醉基础之上联合髂筋膜阻滞麻醉,可以降低老年患者认知功能障碍的出现概率,提高患者神经阻滞镇痛效果,降低丙泊酚等麻醉诱导剂以及麻醉维持期间麻醉药品使用剂量。Objective To analyze the effect of combined spinal epidural anesthesia and iliac fascia block on nerve block and cognitive function in elderly patients undergoing hip surgery. Methods 120 elderly patients with hip surgery treated in our hospital from January 2019 to January 2020 were randomly divided into observation group and control group, with 60 patients in each group. The control group received combined spinal epidural anesthesia, and the observation group received iliac fascia block anesthesia on this basis. The propofol dosage, pain score, adverse reactions and cognitive function score during anesthesia induction were compared between the two groups. The cognitve function of the patients were evaluated by MMSE score standard. Results The dosage of propofol in the observation group was lower than that in the control group, the pain score was lower than that in the control group, and the drug dosage during anesthesia induction was lower than that in the control group, there was a significant difference between the two groups(P<0.05).The cognitive function score in the observation group was higher than that in the control group(P <0.05). Conclusion Combined with iliac fascia block anesthesia on the basis of spinal epidural anesthesia can reduce the probability of cognitive impairment, improve the effect of nerve block, and reduce the dosage of anesthesia inducers such as propofol and narcotic drugs during anesthesia maintenance.

关 键 词：腰硬联合麻醉 髂筋膜阻滞 老年髋关节置换手术 认知功能 

分 类 号：R614[医药卫生—麻醉学] R687.4[医药卫生—外科学]