超声引导下臂丛神经阻滞麻醉在老年桡骨远端粉碎性骨折手术患者中的麻醉效果及对血清Cor、NE水平的影响  

Anesthetic effect of ultrasound-guided brachial plexus nerve block anesthesia in elderly patients with comminuted distal radius fractures and its influences on serum Cor and NE levels

作　　者：见芳琼 陈娜娜 党志梅 JIAN Fangqiong;CHEN Nana;DANG Zhimei(Genertec Universal Crec Railway Xi'an Hospital,Xi'an 710054;Xi'an Daxing Hospital,Xi'an 710016,China)

机构地区：[1]通用环球中铁西安医院,陕西西安710054 [2]西安大兴医院,陕西西安710016

出　　处：《临床医学研究与实践》2024年第14期87-91,共5页Clinical Research and Practice

摘　　要：目的探讨超声引导下臂丛神经阻滞麻醉在老年桡骨远端粉碎性骨折手术患者中的麻醉效果及对血清皮质醇(Cor)、去甲肾上腺素(NE)水平的影响。方法选取2021年10月至2022年10月行手术治疗的200例老年桡骨远端粉碎性骨折患者为研究对象,按照抽签法将其分为对照组和研究组,各100例。两组均行臂丛神经阻滞麻醉,对照组用解剖定位法实施麻醉,研究组在超声引导下实施麻醉。比较两组的麻醉效果、完成麻醉用时、感觉阻滞起效时间、局麻药用量、认知功能、血清Cor、NE水平及并发症发生情况。结果研究组的麻醉优良率高于对照组(P<0.05)。研究组的完成麻醉用时、感觉阻滞起效时间短于对照组,局麻药用量少于对照组(P<0.05)。术后1、3 d,研究组的简易智力状态检查量表(MMSE)评分高于对照组(P<0.05)。麻醉5 min、麻醉结束时,研究组的Cor、NE水平低于对照组(P<0.05)。研究组的并发症总发生率低于对照组(P<0.05)。结论超声引导下臂丛神经阻滞麻醉在老年桡骨远端粉碎性骨折手术中的麻醉效果显著,利于缩短麻醉用时、感觉阻滞起效时间,减少局麻药用量,同时对患者认知功能影响小,安全性高。Objective To investigate the anesthetic effect of ultrasound-guided brachial plexus nerve block anesthesia in elderly patients with comminuted distal radius fractures and its influences on serum cortisol(Cor)and norepinephrine(NE)levels.Methods A total of 200 elderly patients with comminuted distal radius fractures who underwent surgical treatment from October 2021 to October 2022 were selected as the research objects.According to the lottery method,the patients were divided into control group and study group,with 100 cases in each group.Both groups underwent brachial plexus nerve block anesthesia,the control group was anesthetized by anatomical positioning method,and the study group was anesthetized under ultrasound-guided.The anesthesia effect,completion time of anesthesia,onset time of sensory block,local anesthetic dosage,cognitive function,serum Cor,NE levels and complications were compared between the two groups.Results The excellent and good rate of anesthesia in the study group was higher than that in the control group(P<0.05).The completion time of anesthesia and the onset time of sensory block in the study group were shorter than those in the control group,and the local anesthetic dosage was less than that in the control group(P<0.05).At 1 and 3 d after operation,the Mini-Mental State Examination(MMSE)score of the study group was higher than that of the control group(P<0.05).At 5 min of anesthesia and at the end of anesthesia,the levels of Cor and NE in the study group were lower than those in the control group(P<0.05).The total incidence of complications in the study group was lower than that in the control group(P<0.05).Conclusion Ultrasound-guided brachial plexus nerve block anesthesia has a significant anesthetic effect in the operation of comminuted distal radius fractures in the elderly,it is beneficial to shorten the time of anesthesia and the onset time of sensory block,reduce the local anesthetic dosage,and has little effect on the cognitive function of patients,and has high safety.

关 键 词：老年患者 桡骨远端粉碎性骨折 臂丛神经阻滞麻醉 超声 认知功能 

分 类 号：R614[医药卫生—麻醉学]