腰硬联合麻醉与全麻联合神经阻滞麻醉运用于下肢远端骨折患者的比较  

Comparison of Spinal Epidural Anesthesia and General Anesthesia Combined with Nerve Block Anesthesia for Patients with Distal Lower Limb Fractures

作　　者：凌媛 LING Yuan(Anesthesiology Department,Yancheng Tongzhou Orthopedic Hospital,Yancheng,Jiangsu 224000)

机构地区：[1]盐城同洲骨科医院麻醉科,江苏盐城224000

出　　处：《智慧健康》2024年第1期135-138,共4页Smart Healthcare

摘　　要：目的对比分析下肢远端骨折患者手术治疗前采用腰硬联合麻醉方案与全麻联合神经阻滞麻醉方案的效果与安全性。方法选择2021年1月—2022年8月在本院接受手术治疗的下肢远端骨折患者60例作为观察对象,根据麻醉方式的不同划分对照组(30例)与观察组(30例),对照组采取腰硬联合麻醉方案,观察组实施全麻联合神经阻滞麻醉方案,观察对比两组患者麻醉效果,记录两组患者麻醉期间及术后恢复情况,分别监测各组患者麻醉期间血压、心率指标变化,观察各组患者麻醉后出现不良反应的具体表现,统计总发生概率。结果观察组患者麻醉效果明显高于对照组(P<0.05),同时观察组患者感觉阻滞维持时间、运动阻滞维持时间、术后镇痛持续时间均长于对照组,下床活动时间短于对照组(P<0.05)。麻醉10min、30min及手术结束时观察组患者平均动脉压、心率测定值均高于对照组(P<0.05)。两组患者麻醉后不良反应总发生率比较差异无统计学意义(P>0.05)。结论临床手术治疗下肢远端骨折疾病可采取全麻联合神经阻滞麻醉方案,相比腰硬联合麻醉效果更佳,优点是术后疼痛轻,可早期进行功能锻炼,无需留置导尿管等,值得推广。Objective To compare and analyze effect and safety of preoperative lumbar epidural anesthesia and general anesthesia combined with nerve block anesthesia for patients with distal lower limb fractures.Methods The paper chose 60 patients with distal lower limb fractures with surgical treatment in our hospital from January 2021 to August 2022 as observation subjects,and divided them into control group(30 cases)and observation group(30 cases)according to different anesthesia methods.Control group was treated with combined spinal epidural anesthesia scheme,while observation group with combined general anesthesia and nerve block anesthesia scheme.Anesthesia effect between two groups was observed and compared,recovery during and after anesthesia was recorded,changes in blood pressure and heart rate indicators of each group during anesthesia were monitored,specific manifestations of adverse reactions in each group were observed after anesthesia,and total incidence of occurrence was calculated.Results Anesthesia effect of observation group was significantly higher than control group(P<0.05).At the same time,duration of sensory and motor block maintenance,postoperative pain relief in observation group was longer than control group,out of bed time was shorter than control group(P<0.05).Average arterial pressure and heart rate measurements of observation group was higher than control group at 10 and 30 minutes of anesthesia,as well as at the end of surgery(P<0.05).There was no statistically significant difference in total incidence of adverse reactions after anesthesia between two groups(P>0.05).Conclusion Combination of general anesthesia and nerve block anesthesia can achieve better clinical effect than lumbar epidural anesthesia in surgical treatment of distal lower limb fractures,with advantages of mild postoperative pain,early functional exercise,without indwelling catheterization,which is worth promoting.

关 键 词：腰硬联合麻醉 全麻联合神经阻滞麻醉 下肢远端骨折 效果 

分 类 号：R614.2[医药卫生—麻醉学]