腰丛-坐骨神经阻滞麻醉与腰硬联合麻醉分别复合右美托咪定对股骨颈骨折患者的麻醉效果比较  

Lumbar plexus-sciatic nerve block anesthesia versus spinal-epidural combined anesthesia respectively combined with dexmedetomidine for patients with femoral neck fracture

作　　者：丁保峰[1] 刘学佳[1] 邢小明[1] 杨春晓[1] 井玉生[1] DING Baofeng;LIU Xuejia;XING Xiaoming;YANG Chunxiao;JING Yusheng(Liaocheng City Second People′s Hospital of Shandong Province,Liaocheng,Shandong,252600)

机构地区：[1]山东省聊城市第二人民医院,山东聊城252600

出　　处：《实用临床医药杂志》2022年第17期92-95,共4页Journal of Clinical Medicine in Practice

摘　　要：目的 比较腰丛-坐骨神经阻滞麻醉与腰硬联合麻醉分别复合右美托咪定对股骨颈骨折患者的麻醉效果。方法 将80例股骨颈骨折老年患者随机分为对照组和研究组,每组40例。对照组采用腰丛-坐骨神经阻滞麻醉复合右美托咪定,研究组采用腰硬联合麻醉复合右美托咪定。比较2组患者的麻醉效果、麻醉指标水平、麻醉前与术后生命体征变化情况、术后不同时点疼痛评分、不良反应发生情况。结果 研究组麻醉优良率为95.00%,高于对照组的72.50%,差异有统计学意义(P<0.05)。研究组麻醉起效时间、运动神经阻滞持续时间、感觉阻滞持续时间均短于对照组,镇痛维持时间长于对照组,差异均有统计学意义(P<0.05)。2组麻醉前平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_(2))比较,差异无统计学意义(P>0.05);对照组术后MAP、HR较同组术前及同期研究组降低,差异有统计学意义(P<0.05)。研究组术后2、12、24 h疼痛评分均低于对照组,差异有统计学意义(P<0.05)。研究组不良反应发生率为7.50%,低于对照组的25.00%,差异有统计学意义(P<0.05)。结论 腰硬联合麻醉复合右美托咪定可更好地维持老年患者身体机能的稳定,更有利于患者的预后。Objective To compare the anesthetic effect of lumbar plexus-sciatic nerve block anesthesia and combined spinal-epidural anesthesia respectively combined with dexmedetomidine for patients with femoral neck fracture.Methods A total of 80 elderly patients with femoral neck fracture were randomly divided into control group and study group,with 40 cases in each group.The control group was treated with lumbar plexus-sciatic nerve block anesthesia and dexmedetomidine,while the study group was treated with combined spinal-epidural anesthesia and dexmedetomidine.The anesthesia effect,anesthesia indexes,changes of vital signs before and after anesthesia,pain scores at different time points after operation,and adverse reactions were compared between the two groups.Results The excellent and good rate of anesthesia in the study group was 95.00%,which was significantly higher than 72.50% in the control group(P0.05);the MAP and HR after operation in the control group were significantly lower than those before operation in the same group and in the same period in the study group(P<0.05).The pain scores of the study group were significantly lower than those of the control group at 2,12 and 24 hours after operation( P < 0.05).The incidence of adverse reactions in the study group was 7.50%,which was significantly lower than 25.00% in the control group( P < 0.05).Conclusion Combined spinal-epidural anesthesia and dexmedetomidine can better maintain the stability of physical function of elderly patients,which is more favorable for the prognosis of patients.

关 键 词：腰丛-坐骨神经阻滞麻醉 腰硬联合麻醉 右美托咪定 股骨颈骨折 不良反应 

分 类 号：R614[医药卫生—麻醉学] R683[医药卫生—外科学]