超声引导下神经阻滞对高龄危重患者股骨头置换术的麻醉效果分析  

Analysis of the Effect of Ultrasound-guided Nerve Block on Elderly Patients Undergoing Femoral Head Replace⁃ment

作　　者：王艳 WANG Yan(Department of Anesthesiology,Luoyang Orthopedic-Traumatological Hospital of Henan Province,Henan Provincial Orthopedic Hospital,Luoyang,Henan,471000,China)

机构地区：[1]河南省洛阳正骨医院?河南省骨科医院麻醉科,河南洛阳471000

出　　处：《黑龙江医学》2022年第3期261-262,265,共3页Heilongjiang Medical Journal

摘　　要：目的:分析高龄危重患者股骨头置换术患者采用超声引导下神经阻滞的麻醉效果。方法:选取2016年8月—2020年8月行股骨头置换术的580例高龄危重患者为研究对象,均在超声引导行神经阻滞麻醉。分析患者神经阻滞麻醉效果、不同时间点[麻醉前(T0)、麻醉后5min(T1)、麻醉后10min(T2)、麻醉后30min(T3)、麻醉后60min(T4)]血流动力学[血氧饱和度(SpO_(2))、心率(HR)、舒张压(DBP)和收缩压(SBP)]变化以及感觉、运动阻滞起效时间及维持时间。结果:所有患者均顺利完成神经阻滞,其中神经阻滞效果Ⅰ级有545例(93.97%),Ⅱ级有35例(6.03%)。运动阻滞起效时间和维持时间分别为(9.79±2.01)min、(186.57±42.13)min,感觉阻滞起效时间和维持时间分别为(5.41±1.70)min、(425.78±44.58)min。患者T0、T1、T2、T3、T4时点SpO_(2)、HR、DBP和SBP比较,差异有统计学意义(F=20.825、22.736、10.267、40.554,P<0.05),但各指标均在正常范围内波动。结论:高龄危重患者股骨头置换术患者采用超声引导下神经阻滞麻醉效果较好,对患者血流动力学影响较小,有助于患者平稳度过整个围术期。Objective:To analyze the anesthesia effect of ultrasound-guided nerve block in elderly critical patients undergoing femoral head replacement.Methods:From August 2016 to August 2020,580 elderly critically ill patients undergoing femoral head replacement in the hospital were selected.All of them were under ultrasound-guided nerve block anesthesia.The effect of nerve block anesthesia,hemodynamic changes and sensation(SpO_(2),heart rate[HR],diastolic blood pressure[DBP]and systolic blood pressure[SBP])at different time points(before anesthesia[T0],5 min after anesthesia[T1],10 min after anesthesia[T2],30 min af⁃ter anesthesia[T3],60 min after anesthesia[T4]),the onset time and maintenance time of motor block were analyzed.Results:All patients successfully completed the nerve block.Among them,545 cases(93.97%)of nerve block were grade I and 35 cases(6.03%)were grade II.The onset and maintenance time of motor block were(9.79±2.01)min and(186.57±42.13)min,respectively.The onset and maintenance time of sensory block were(5.41±1.70)min and(425.78±44.58)min,respectively.There was statistical⁃ly significant difference between SpO_(2),HR,DBP and SBP at T0,T1,T2,T3,and T4(F=20.825,22.736,10.267,40.544,P<0.05),but each index fluctuated within the normal range.Conclusion:The effect of ultrasound-guided nerve block anesthesia in elderly critically ill patients undergoing femoral head replacement is better,and it has little influence on hemodynamics,which is helpful for patients to pass the whole perioperative period smoothly.

关 键 词：股骨颈骨折 股骨头置换术 超声检查 神经阻滞 

分 类 号：R657.4[医药卫生—外科学]