老年髋部手术行超声引导麻醉药物髂筋膜间隙阻滞的效果  

Effect of Ultrasound-Guided Anesthesia Drug Fascia Iliac Space Block in Elderly Hip Surgery

作　　者：易建红 王洋 YI Jianhong;WANG Yang(Department of Anesthesia and Pain,Nanfang Hospital Taihe Branch,Guangzhou Guangdong 510540,China)

机构地区：[1]南方医院太和分院麻醉疼痛科,广东广州510540

出　　处：《中国卫生标准管理》2023年第20期123-126,共4页China Health Standard Management

摘　　要：目的研究老年髋部手术患者应用超声引导下罗哌卡因混合右美托咪定髂筋膜间隙阻滞麻醉的作用与效果。方法抽取南方医院太和分院2022年2月—2023年2月收治的80例老年髋部手术患者作为研究对象。根据随机数字表法分为对照组和观察组,每组40例。对照组患者给予超声引导下罗哌卡因髂筋膜间隙阻滞,观察组患者给予超声引导下罗哌卡因混合右美托咪定髂筋膜间隙阻滞。针对两组患者治疗前后的视觉模拟评分法(visual analogue scale,VAS)、血流动力学指标、阻滞相关指标及不良反应情况等进行比较。结果治疗前,两组VAS评分及血流动力学指标比较,差异无统计学意义(P>0.05);治疗后,观察组VAS评分、心率(heart rate,HR)及平均动脉压(mean arterial pressure,MAP)低于对照组(P<0.05),两组脉搏血氧饱和度(saturation of blood oxygen,SpO_(2))比较,差异无统计学意义(P>0.05);两组治疗前后VAS评分及血流动力学指标比较,差异有统计学意义(P<0.05)。观察组患者阻滞起效时间、下床活动时间及住院时间短于对照组,阻滞消退时间长于对照组,差异有统计学意义(P<0.05)。观察组患者不良反应总发生率为7.50%,相比于对照组的12.50%,差异无统计学意义(P>0.05)。结论老年髋部手术患者应用超声引导下罗哌卡因混合右美托咪定髂筋膜间隙阻滞具有更确切的麻醉效果及安全性,并减轻疼痛。Objective To investigate the effect of ultrasondguided ropivacaine combined with dexmedetomidine in iliac fascia space block anesthesia in elderly patients undergoing hip surgery.Methods A total of 80 elderly patients with hip operation admitted to Nanfang Hospital Taihe Branch from February 2022 to February 2023 were selected as the research objects.According to random number table method,the patients were divided into control group and observation group,40 cases in each group.Control group was given ultrasond-guided ropivacaine iliac fascia space block,observation group was given ultrasond-guided ropivacaine combined with dexmedetomidine iliac fascia space block.Visual analogue scale(VAS),hemodynamic indexes,block-related indexes and adverse reactions were compared between the two groups before and after treatment.Results There were no significant differences in VAS score and hemodynamic indexes between the groups before treatment(P>0.05).After treatment,the VAS score,heart rate(HR)and mean arterial pressure(MAP)of the observation group were lower than those of the control group(P<0.05),there was no significant difference in saturation of blood oxygen(SpO_(2))between the two groups(P>0.05).VAS scores and hemodynamic indexes before and after treatment between the two groups were significantly different(P<0.05).The time of block onset,time of getting out of bed and length of hospital stay in the observation group were shorter than those in the control group,and the time of block resolution was longer than those in the control group,with statistical significance(P<0.05).The total incidence of adverse reactions in observation group was 7.50%,compared with 12.50%in control group,and the difference was not statistically significant(P>0.05).Conclusion The use of ultrasound-guided ropivacaine combined with dexmedetomidine iliofascial space block in elderly patients undergoing hip surgery has more accurate anesthetic effects and safety,and reduce pain.

关 键 词：超声引导 罗哌卡因 右美托咪定 髂筋膜间隙阻滞 临床麻醉 髋部手术 

分 类 号：R614[医药卫生—麻醉学]