B超定位下下肢神经阻滞辅助右美托咪定泵注对髋关节置换术患者麻醉效果及呼吸循环功能的影响  

Effects of B-ultrasound guided lower limb nerve block assisted dexmedetomidine pumping on anesthesia effect and respiratory and circulatory function in patients undergoing hip replacement

作　　者：李海英[1] 马荷荷 LI Haiying;MA Hehe(Anesthesiology Department,Yan'an People's Hospital,Yan'an 716000,China)

机构地区：[1]延安市人民医院麻醉科,陕西延安716000

出　　处：《临床医学研究与实践》2023年第14期50-53,共4页Clinical Research and Practice

摘　　要：目的探究B超定位下下肢神经阻滞辅助右美托咪定泵注在髋关节置换术中的应用效果。方法选取2018年4月至2021年3月收治的60例行髋关节置换术的患者,根据随机数字表法将其分为对照组(n=30)与观察组(n=30)。对照组采用全身麻醉辅助右美托咪定泵注,观察组采用B超定位下下肢神经阻滞辅助右美托咪定泵注。比较两组的视觉模拟评分法(VAS)评分、心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO2)、呼吸频率(RR)、P物质(SP)、β-内啡肽(β-EP)、5-羟色胺(5-HT)、前列腺素E2(PGE2)、神经肽Y(NPY)水平及不良反应发生情况。结果术后2、6、12、24 h,观察组的VAS评分低于对照组(P<0.05)。麻醉即刻(T1)、切皮时(T2)、手术30 min时(T3),两组的MAP、RR比较,差异具有统计学意义(P<0.05);T1、T2、T3时,两组的HR、MAP、RR与入室后(T0)比较,差异具有统计学意义(P<0.05);术毕时(T4),两组的HR、MAP、SpO2比较,差异无统计学意义(P>0.05)。术前,两组的SP、β-EP、5-HT、PGE2、NPY水平比较,差异无统计学意义(P>0.05);术中、术后1 d,两组的SP、β-EP、5-HT、PGE2、NPY水平高于术前,差异具有统计学意义(P<0.05);术中、术后1 d,观察组的SP、β-EP、5-HT、PGE2、NPY水平低于对照组,差异具有统计学意义(P<0.05)。两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论B超定位下下肢神经阻滞辅助右美托咪定泵注应用于髋关节置换术中麻醉效果好,对呼吸循环功能影响小,安全性高。Objective To explore the application effect of B-ultrasound guided lower limb nerve block assisted dexmedetomidine pumping in hip replacement.Methods Sixty patients undergoing hip replacement from April 2018 to March 2021 were selected and divided into control group(n=30)and observation group(n=30)according to the random number table method.The control group was treated with general anesthesia assisted dexmedetomidine pumping,and the observation group was treated with B-ultrasound guided lower limb nerve block assisted dexmedetomidine pumping.The Visual Analogue Scale(VAS)score,heart rate(HR),mean arterial pressure(MAP),saturation of peripheral oxygen(SpO2),respiratory rate(RR),substance P(SP),β-endorphin(β-EP),5-hydroxytryptamine(5-HT),prostaglandin E2(PGE2),neuropeptide Y(NPY)levels and adverse reactions of the two groups were compared.Results At 2,6,12 and 24 h after operation,the VAS score of the observation group was lower than that of the control group(P<0.05).At the time of anesthesia(T1),skin incision(T2)and 30 min of operation(T3),there were significant differences in MAP and RR between the two groups(P<0.05);at T1,T2 and T3,the HR,MAP and RR of the two groups were significantly different from those at after admission(T0)(P<0.05);at the end of operation(T4),there were no significant differences in HR,MAP and SpO2 between the two groups(P>0.05).Before operation,there were no significant differences in the levels of SP,β-EP,5-HT,PGE2 and NPY between the two groups(P>0.05);during operation and 1 d after operation,the levels of SP,β-EP,5-HT,PGE2 and NPY in the two groups were higher than those before operation,and the differences were statistically significant(P<0.05);during operation and 1 d after operation,the levels of SP,β-EP,5-HT,PGE2 and NPY in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion The B-ultra

关 键 词：髋关节置换术 B超引导 下肢神经阻滞 右美托咪定 

分 类 号：R614[医药卫生—麻醉学]