超声引导坐骨神经阻滞复合全麻对全麻全髋关节置换围术期血氧饱和度及苏醒时间的影响  

Influence of ultrasound-guided sciatic nerve block combined with general anesthesia on blood oxygen saturation during perioperative period of total hip replacement and recovery time

作　　者：张惠梅 张宇[2] 冯国伟 Zhang Huimei;Zhang Yu;Feng Guowei(Department of anesthesiology,Henan electric power hospital,Zhengzhou,Henan,450000,China;Department of anesthesiology,Zhengzhou orthopaedics hospital,Zhengzhou,Henan,450000,China)

机构地区：[1]河南电力医院麻醉科,河南郑州450000 [2]郑州市骨科医院麻醉科,河南郑州450000

出　　处：《齐齐哈尔医学院学报》2022年第24期2335-2338,共4页Journal of Qiqihar Medical University

摘　　要：目的探究超声引导坐骨神经阻滞复合全麻对全麻全髋关节置换围术期血氧饱和度(SpO2)及苏醒时间的影响。方法选择2018年5月—2021年5月本院收治的40例行全髋关节置换术的患者作为研究对象,按麻醉方式分为A组(采用单纯插管全麻,18例)和B组(采用超声引导坐骨神经阻滞复合全麻,22例)两组。比较两组患者围术期血氧饱和度SpO2、苏醒时间、术后疼痛VAS评分情况及麻醉不良反应。结果两组患者T1-T4时的SpO2均低于T0时,差异有统计学意义(P<0.05);两组患者T0时的SpO2比较,差异无统计学意义(P>0.05);B组患者T1-T4时SpO2均高于A组,差异有统计学意义(P<0.05);B组患者苏醒时间显著短于A组,差异有统计学意义(P<0.05);B组患者术后2 h、12 h、1 d、2 d的疼痛VAS评分显著低于A组,差异有统计学意义(P<0.05);B组患者头痛、恶心呕吐与低血压的麻醉不良反应发生率显著低于A组,差异有统计学意义(P<0.05)。结论在全髋关节置换术中应用超声引导坐骨神经阻滞复合全麻与仅采用插管全麻相比,超声引导坐骨神经阻滞复合全麻可改善患者SpO2降低幅度、缩短术后苏醒时间、减少疼痛与不良反应发生情况,是一种效果显著、安全性高的麻醉方式,值得临床推广。Objective To investigate the influence of ultrasound-guided sciatic nerve block combined with general anesthesia on blood oxygen saturation(SpO2)during perioperative period of total hip replacement and recovery time.Methods 40 patients who ever underwent total hip replacement in the hospital during May 2018 to May 2021 were enrolled as study subjects.Patients receiving simple general anesthesia were included in group A(n=18),while patients receiving ultrasound-guided sciatic nerve block combined with general anesthesia were included in group B(n=22).Perioperative SpO2,recovery time,postoperative pain(VAS score)and adverse anesthesia reactions were compared between the two groups.Results Compared with T0,SpO2in both groups decreased at T1-T4(P<0.05).There was no significant difference in SpO2between the two groups at T0(P>0.05).SpO2in group B was higher than that in group A at T1-T4(P<0.05).The postoperative recovery time of group B was was shorter than that of group A(P<0.05).The VAS scores of group B at 2 h,12 h,1d and 2 d after operation were significantly lower than those of group A(P<0.05).The incidence of adverse anesthesia reactions such as headache,nausea,vomiting and hypotension in group B were significantly lower than those in group A(P<0.05).Conclusions Compared with simple general anesthesia,ultrasound-guided sciatic nerve block combined with general anesthesia could improve the decrease amplitude of SpO2 in patients undergoing total hip replacement,shorten their postoperative recovery time,and reduce pain and adverse reactions.It is an effective and safe anesthetic method,worth of clinical application.

关 键 词：髋关节置换术 超声 神经阻滞 麻醉 血氧饱和度 

分 类 号：R614[医药卫生—麻醉学]