超声引导下肢神经阻滞复合右美托咪定在老年股骨颈骨折术中的应用  

Application of Ultrasound-guided Lower Limb Nerve Block Combined with Dexmedetomidine in Elderly Patients with Femoral Neck Fracture Surgery

作　　者：顾强强 GU Qiangqiang(Department of Anesthesiology,Huichang County People's Hospital,Huichang 342600,Jiangxi,China)

机构地区：[1]会昌县人民医院麻醉科,江西会昌342600

出　　处：《医学信息》2024年第24期33-36,共4页Journal of Medical Information

摘　　要：目的观察超声引导下肢神经阻滞复合右美托咪定在老年股骨颈骨折术中的应用效果。方法选取2021年7月-2024年6月会昌县人民医院收治的62例老年股骨颈骨折患者作为研究对象,按照随机数字表法将其分为对照组和研究组,每组31例。对照组予以右美托咪定复合全身麻醉,研究组行超声引导下肢神经阻滞复合右美托咪定麻醉。比较两组血流动力学指标[收缩压(SBP)、舒张压(DBP)、心率(HR)]、阻滞起效时间和维持时间、镇静镇痛状况、不良反应发生率(穿刺点感染、呼吸困难、恶心呕吐、头晕)。结果两组T0、T1、T2、T3、T4时SBP比较,差异无统计学意义(P>0.05);两组T0时DBP和HR比较,差异无统计学意义(P>0.05);研究组T1、T2时DBP、HR高于对照组,T3、T4时低于对照组(P<0.05)。两组感觉阻滞以及运动阻滞起效时间比较,差异无统计学意义(P>0.05);研究组感觉阻滞以及运动阻滞维持时间均长于对照组(P<0.05);两组术后6、12、24 h Ramsay评分比较,差异无统计学意义(P>0.05);研究组术后6、12、24 h NRS评分低于对照组(P<0.05);研究组不良反应发生率低于对照组(P<0.05)。结论超声引导下肢神经阻滞复合右美托咪定在老年股骨颈骨折术中的应用效果确切,有利于稳定患者血流动力学状态,提高神经阻滞效果,术后镇痛时间更长,且安全性较高。Objective To observe the application effect of ultrasound-guided lower limb nerve block combined with dexmedetomidine in elderly patients with femoral neck fracture.Methods A total of 62 elderly patients with femoral neck fracture admitted to Huichang County People's Hospital from July 2021 to June 2024 were selected as the research objects.According to the random number table method,they were divided into control group and study group,with 31 patientsin each group.The control group was given dexmedetomidine combined with general anesthesia,and the study group was given ultrasound-guided lower limb nerve block combined with dexmedetomidine anesthesia.The hemodynamic indexes[systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR)],block onset time and maintenance time,sedation and analgesia status,incidence of adverse reactions(puncture point infection,dyspnea,nausea and vomiting,dizziness)were compared between the two groups.Results There was no significant difference in SBP between the two groups at T0,T1,T2,T3 and T4(P>0.05).There was no significant difference in DBP and HR between the two groups at T0(P>0.05).DBP and HR in the study group were higher than those in the control group at T1 and T2,and lower than those in the control group at T3 and T4(P<0.05).There was no significant difference in the onset time of sensory block and motor block between the two groups(P>0.05),but the duration of sensory block and motor block in the study group was longer than that in the control group(P<0.05).The NRS score of the study group at 6,12 and 24 h after operation was lower than that of the control group(P<0.05).The incidence of adverse reactions in the study group was lower than that in the control group(P<0.05).Conclusion Ultrasound-guided lower extremity nerve block combined with dexmedetomidine is effective in the treatment of femoral neck fracture in the elderly.It is beneficial to stabilize the hemodynamic status of patients,improve the effect of nerve block,prolong the postoperative analgesia tim

关 键 词：超声引导 下肢神经阻滞 右美托咪定 老年股骨颈骨折 

分 类 号：R614[医药卫生—麻醉学]