对比腰丛-坐骨神经阻滞、腰硬联合麻醉在全髋关节置换手术的效果  

Comparison of the Effects of Lumbar Plexus-Sciatic Nerve Block and Combined Spinal-Epidural Anesthesia in Total Hip Replacement Surgery

作　　者：许来凤 刘娇 XU Laifeng;LIU Jiao(the First Hospital of Hohhot,Hohhot 010010,China)

机构地区：[1]呼和浩特市第一医院,内蒙古呼和浩特010010

出　　处：《中国医药指南》2023年第8期6-9,共4页Guide of China Medicine

摘　　要：目的比较腰丛-坐骨神经阻滞麻醉和腰硬联合麻醉在全髋关节置换术手术中所发挥的麻醉效果差异。方法将2021年1月至2022年1月于我院治疗的94例全髋关节置换术治疗的患者以随机方法分为观察组和对照组,各47例。对照组患者实施腰从-坐骨神经阻滞麻醉,观察组患者实施腰硬联合麻醉,统计不同麻醉后的麻醉质量、疼痛情况、不良反应发生率、生活质量、睡眠质量、满意度等,并对相关的数据进行统计学比较。结果两组的麻醉药物起效时间、麻醉阻滞时间、拔管时间、苏醒时间、Ramsay评分之间的差异无统计学意义(P>0.05);观察组患者的术后24 h疼痛、镇痛泵按压次数、镇痛泵剩余药量与对照组的差异无统计学意义(P>0.05);观察组(5例,占10.64%)不良反应发生率和对照组(6例,占12.77%)相比差异无统计学意义(P>0.05);麻醉前,两组患者的PSQI评分差异无统计学意义(P>0.05),麻醉后,两组患者的PSQI评分之间差异无统计学意义(P>0.05);观察组(43例,占91.49%)患者对麻醉的满意度对照组(44例,占93.62%)患者相比,差异无统计学意义(P>0.05)。结论对全髋关节置换术治疗的患者实施腰丛坐骨股神经阻滞麻醉和腰硬联合麻醉均可以获取良好的麻醉质量,而且2种麻醉方法在麻醉质量、疼痛、不良反应、睡眠质量和满意度等方面所获取的麻醉效果没有显著差异,可以根据患者的需求合理的选择麻醉方法。Objective To compare the anesthesia effect of lumbar plexus sciatic nerve block anesthesia and combined spinal-epidural anesthesia in total hip arthroplasty.Methods A total of 94 patients with total hip arthroplasty who were treated in our hospital from January 2021 to January 2022 were randomly divided into an observation group and a control group,with 47 cases in each group.The patients in the control group were given lumbar-sciatic nerve block anesthesia,and the patients in the observation group were given combined spinal-epidural anesthesia.Data were statistically compared.Results There was no significant difference in the onset time of anesthesia,anesthesia block time,extubation time,recovery time and Ramsay score between the two groups(P>0.05).There was no significant difference in pain 24 hours after operation,analgesic pump pressing times and remaining dose of analgesic pump in the observation group and the control group(P>0.05);the incidence of adverse reactions in the observation group(5 cases,accounting for 10.64%)and the control group(6 cases,accounting for 12.77%),the difference was not significant(P>0.05).Before anesthesia,the PSQI scores of the two groups of patients had no significant difference(P>0.05),and after anesthesia,the PSQI scores of the two groups of patients were different,there was no significant difference(P>0.05);the patients in the observation group(43 cases,accounting for 91.49%)had no significant difference in satisfaction with the anesthesia compared with the control group(44 cases,accounting for 93.62%)patients(P>0.05).Conclusion Both lumbar plexus femoral nerve block anesthesia and medical combined anesthesia can achieve good anesthesia quality in patients treated with total hip arthroplasty,and the two anesthesia methods have significant effects on anesthesia quality,pain,adverse reactions,sleep quality and satisfaction.There is no significant difference in the anesthesia effect obtained in other aspects,and the anesthesia method can be reasonably selected according to the nee

关 键 词：全髋关节置换术 腰丛-坐骨神经阻滞 腰硬联合麻醉 麻醉质量 疼痛 拔管 

分 类 号：R614[医药卫生—麻醉学]