超声引导下髂筋膜神经阻滞联合全身麻醉在老年股骨近端骨折患者中的应用效果  

Application Effect of Ultrasound-guided Iliaca Fascia Nerve Block Combined with General Anesthesia in Elderly Patients with Proximal Femoral Fracture

作　　者：龙波 杨代和[1] 杨丽君 LONG Bo;YANG Daihe;YANG Lijun(Fujian Second People's Hospital,Fuzhou 350001,China;不详)

机构地区：[1]福建省第二人民医院,福建福州350001 [2]福建省妇幼保健院

出　　处：《中外医学研究》2024年第32期45-48,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨超声引导下髂筋膜神经阻滞联合全身麻醉在老年股骨近端骨折患者中的应用效果。方法:选取2021年1月-2023年1月于福建省第二人民医院进行治疗的80例老年股骨近端骨折患者作为研究对象,按照随机数表法将其分为对照组(常规全麻,40例)与观察组(超声引导下髂筋膜神经阻滞联合全身麻醉,40例)。比较两组麻醉效果、血流动力学、疼痛情况[视觉模拟评分法(VAS)、前列腺素E_(2)(PGE_(2))、血清P物质(SP)]。结果:观察组丙泊酚、瑞芬太尼用量较对照组少,拔管时间、苏醒时间较对照组早,差异有统计学意义(P<0.05);观察组气管插管时、手术开始5 min后、手术结束时平均动脉压较对照组高,心率较对照组低,差异有统计学意义(P<0.05);术后24 h,两组VAS评分及PGE_(2)、SP水平高于术后2 h,但观察组低于对照组,差异有统计学意义(P<0.05)。结论:老年股骨近端骨折患者采用超声引导下髂筋膜神经阻滞联合全身麻醉,可有效减少麻醉药物用量,缩短拔管、苏醒时间,稳定血流动力学,缓解疼痛。Objective:To explore the effect of application effect of ultrasound-guided iliaca fascia nerve block combined with general anesthesia in elderly patients with proximal femoral fracture.Method:A total of 80 elderly patients with proximal femoral fracture who treated in Fujian Second People's Hospital from January 2021 to January 2023 were selected as the research objects,they were divided into the control group(conventional general anesthesia,40 cases)and the observation group(ultrasound-guided iliaca fascia nerve block combined with general anesthesia,40 cases)according to the random number table method.The anesthesia effect,hemodynamics and pain[visual analogue scale(VAS),prostaglandin E2(PGE2),serum substance P(SP)]were compared between two groups.Result:The dosages of Propofol and Remifentanil in the observation group were less than those in the control group,and the extubation time and recovery time were shorter than those in the control group,the differences were statistically significant(P<0.05);the mean arterial pressures of the observation group at the time of tracheal intubation,5 min after the beginning of operation and end of operation were higher than those of the control group,and the heart rate were lower than those of the control group,the differences were statistically significant(P<0.05);at 24 h after operation,the VAS scores and the levels of PGE2 and SP in two groups were higher than those at 2 h after operation,but those in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion:Ultrasound-guided iliaca fascia nerve block combined with general anesthesia in elderly patients with proximal femoral fracture can effectively reduce the amount of anesthetic drugs,shorten the extubation and recovery times,stabilize hemodynamics and relieve pain.The use of combined anesthesia during surgery for proximal femoral fractures in the elderly can effectively reduce anesthesia dosage,shorten hospital stay,alleviate pain,and stabilize h

关 键 词：血流动力学 全身麻醉 髂筋膜神经阻滞 股骨近端骨折 

分 类 号：R614.2[医药卫生—麻醉学]