超声引导下神经阻滞麻醉在股骨颈骨折手术中的应用效果及安全性分析  

Efficacy and safety analysis of ultrasound-guided nerve block anesthesia in femoral neck fracture surgery

作　　者：俞平刚 YU Pinggang(Department of Anesthesiology,Xingan Hospital for Head and Bone Injuries,Guilin 541305,Guangxi,China)

机构地区：[1]兴安界首骨伤医院麻醉科,广西桂林541305

出　　处：《当代医药论丛》2022年第9期79-81,共3页

摘　　要：目的:探讨对接受手术治疗的股骨颈骨折患者进行超声引导下神经阻滞麻醉的效果及安全性。方法:选取近年来在兴安界首骨伤医院进行手术治疗的100例股骨颈骨折患者作为研究对象。按照术中麻醉方法的不同将其分为复合麻醉组和神经阻滞组。术中对复合麻醉组患者进行静吸复合麻醉,对神经阻滞组患者进行超声引导下神经阻滞麻醉,然后比较两组患者的各项临床指标。结果:神经阻滞组患者感觉阻滞起效的时间短于复合麻醉组患者,其运动阻滞起效的时间及感觉阻滞和运动阻滞持续的时间均长于复合麻醉组患者,P<0.05。术后30 min,神经阻滞组患者血清白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)的水平均低于复合麻醉组患者,P<0.05。术后6 h、12 h及24 h,神经阻滞组患者切口周围皮肤的机械痛阈值均高于复合麻醉组患者,P<0.05。神经阻滞组患者麻醉不良反应的发生率低于复合麻醉组患者,P<0.05。结论:对接受手术治疗的股骨颈骨折患者进行超声引导下神经阻滞麻醉的效果显著,能有效缩短其感觉阻滞起效的时间,延长其感觉阻滞和运动阻滞持续的时间,减轻其术后的炎症反应和疼痛的程度,且麻醉的安全性较高。Objective:To investigate the efficacy and safety of ultrasound-guided nerve block anesthesia in patients with femoral neck fracture undergoing surgical treatment.Methods:100 patients with femoral neck fracture who underwent surgical treatment in Xingan District head bone Injury Hospital in recent years were selected as the research object.According to the different anesthesia methods,they were divided into compound anesthesia group and nerve block group.Intraoperatively,patients in the combined anesthesia group were subjected to intravenous inhalation combined anesthesia,and patients in the nerve block group were subjected to ultrasound-guided nerve block anesthesia,and then the clinical indicators of the two groups were compared.Results:The onset time of sensory block in nerve block group was shorter than that in combined anesthesia group,and the onset time of motor block and the duration of sensory block and motor block were longer than that in combined anesthesia group,P<0.05.The levels of serum interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in nerve block group were lower than those in combined anesthesia group 30 min after surgery,P<0.05.At 6 h,12 h and 24 h after surgery,the mechanical pain threshold of skin around incision in nerve block group was higher than that in combined anesthesia group,P<0.05.The incidence of adr in nerve block group was lower than that in combined anesthesia group(P<0.05).Conclusion:Ultrasound-guided nerve block anesthesia has a significant effect on patients with femoral neck fracture undergoing surgical treatment,which can effectively shorten the onset time of sensory block,prolong the duration of sensory block and motor block,reduce postoperative inflammatory response and pain,and has a high safety of anesthesia.

关 键 词：手术 股骨颈骨折 超声引导下神经阻滞麻醉 静吸复合麻醉 不良反应 

分 类 号：R614[医药卫生—麻醉学]