超声联合神经刺激仪引导阻滞在老年高危患者全髋关节置换术中的效果分析  

Effect of ultrasound combined with nerve stimulator guided block in total hip arthroplasty in elderly high-risk patients

作　　者：张宝剑 徐娟[1] ZHANG Baojian;XU Juan(Department of Anesthesiology,The Fourth Division Hospital,Xinjiang Production and Construction Corps,Yili,835000,Xinjiang,China)

机构地区：[1]新疆生产建设兵团第四师医院麻醉科,新疆伊犁835000

出　　处：《新疆医学》2022年第2期196-198,共3页Xinjiang Medical Journal

摘　　要：目的探究对行全髋关节置换术老年高危患者实施超声联合神经刺激仪引导下腰丛+坐骨神经阻滞的效果。方法随机将2018年3月-2019年10月本院60例行全髋关节置换术老年高危患者分为对照组(30例,应用硬膜外麻醉)、试验组(30例,应用超声联合神经刺激仪引导下腰丛+坐骨神经阻滞麻醉)。对比两组血流动力学指标、神经阻滞恢复时间、麻醉效果及不良反应发生率。结果试验组T1、T2、T3时刻心率较对照组更低,且平均动脉压较对照组更高,P<0.05;试验组麻醉优良率、神经阻滞恢复时间和对照组无显著差异,P>0.05;试验组不良反应发生率低于对照组,P<0.05。结论对行全髋关节置换术老年高危患者实施超声联合神经刺激仪引导下腰丛+坐骨神经阻滞可获得较好的麻醉效果,且对血流动力学影响较小,安全性较高。Objective To explore the effect of ultrasound combined with nerve stimulator guided lumbar plexus+sciatic nerve block in elderly high-risk patients undergoing total hip arthroplasty.Methods 60 elderly high-risk patients undergoing total hip replacement in our hospital from March 2018 to October 2019 were randomly divided into control group(30 cases,epidural anesthesia)and experimental group(30 cases,lumbar plexus+sciatic nerve block anesthesia under the guidance of ultrasound combined with nerve stimulator).Hemodynamic indexes,recovery time of nerve block,anesthetic effect and incidence of adverse reactions were compared between the two groups.Results The heart rate at T1,T2 and T3 in the experimental group was lower than that in the control group,and the mean arterial pressure was higher than that in the control group(P<0.05);there was no significant difference in the excellent and good rate of anesthesia and the recovery time of nerve block between the experimental group and the control group(P>0.05);the incidence of adverse reactions in the experimental group was lower than that in the control group(P<0.05).Conclusion Lumbar plexus and sciatic nerve block under the guidance of ultrasound combined with nerve stimulator can obtain better anesthetic effect in elderly high-risk patients undergoing total hip arthroplasty,with less impact on hemodynamics and higher safety.

关 键 词：全髋关节置换术 老年 高危 超声 神经刺激仪 腰丛+坐骨神经阻滞 

分 类 号：R687.43[医药卫生—骨科学]