神经阻滞联合椎管内麻醉对老年患者下肢骨折手术后谵妄情况的影响  

Effect of Nerve Block Combined with Intraspinal Anesthesia on Postoperative Delirium of Lower Limb Fracture Surgery in Elderly Patients

作　　者：刘卫廷 张颖 张微 LIU Weiting;ZHANG Ying;ZHANG Wei(Beijing Red Cross Emergency Rescue Center,Beijing 100085,China;不详)

机构地区：[1]北京市红十字会急诊抢救中心,北京100085

出　　处：《中国医学创新》2022年第12期60-63,共4页Medical Innovation of China

摘　　要：目的:探讨神经阻滞联合椎管内麻醉对老年患者下肢骨折手术后谵妄情况的影响。方法:将2020年1-12月在北京市红十字会急诊抢救中心接受下肢骨折手术的80例老年患者随机分为两组,对照组接受椎管内麻醉,研究组在对照组的基础上加用神经阻滞麻醉。对比两组麻醉效果、围术期血压及心率、疼痛情况、术后谵妄情况。结果:研究组麻醉总有效率高于对照组(P<0.05)。两组麻醉前血压、心率比较,差异均无统计学意义(P>0.05),麻醉后不同时间点、手术结束时,研究组SBP、DBP均高于对照组(P<0.05),两组HR对比,差异均无统计学意义(P>0.05)。研究组术后12、24 h的VAS评分均低于对照组(P<0.05);研究组术后DRS-R-98量表评分低于对照组(P<0.05)。结论:下肢骨折手术老年患者接受神经阻滞联合椎管内麻醉,麻醉效果尚佳,可有效减轻麻醉对血液循环功能的影响,降低术后疼痛,减少术后谵妄情况的发生,该联合麻醉方式在临床上具有较高推广价值。Objective:To investigate the effect of nerve block combined with intraspinal anesthesia on postoperative delirium of lower limb fracture surgery in elderly patients.Method:A total of 80 elderly patients who underwent lower limb fracture surgery in Beijing Red Cross Emergency Rescue Center from January to December 2020 were randomly divided into two groups,the control group received intraspinal anesthesia,and the study group received nerve block anesthesia on the basis of the control group.The anesthetic effect,perioperative blood pressure and heart rate,pain and postoperative delirium were compared between the two groups.Result:The anesthetic total effect rate in the study group was higher than that in the control group (P<0.05).There were no significant differences in blood pressure and heart rate between the two groups before anesthesia (P>0.05),the SBP and DBP in the study group were higher than those in the control group at different time points after anesthesia and at the end of operating (P<0.05),there was no significant difference in HR between the two groups (P>0.05).The VAS scores of the study group were lower than those of the control group at 12,24 h after operation (P<0.05);the score of DRS-R-98 in the study group was lower than that in the control group (P<0.05).Conclusion:Nerve block combined with intraspinal anesthesia in elderly patients undergoing lower limb facture surgery has good anesthesia effect,which can effectively reduce the influence of anesthesia on blood circulation function,reduce postoperative pain and reduce the occurrence of postoperative delirium,this combined anesthesia method has a high promotion value in clinical practice.

关 键 词：神经阻滞 椎管内麻醉 老年患者 下肢骨折手术 麻醉效果 谵妄 

分 类 号：R614[医药卫生—麻醉学]