腰骶丛神经阻滞复合小剂量丙泊酚麻醉在老年股骨颈骨折手术中的应用  

Application of Lumbosacral Plexus Block Combined with Low Dose Propo⁃fol Anesthesia in Elderly Patients with Femoral Neck Fracture

作　　者：柳碧霞 陈晓梅 LIU Bixia;CHEN Xiaomei(Department of Anesthesiology,Fuzhou Second General Hospital,Fuzhou,Fujian,350004,China)

机构地区：[1]福州市第二总医院麻醉科,福建福州350004

出　　处：《中外医疗》2025年第4期77-80,共4页China & Foreign Medical Treatment

摘　　要：目的 评估老年股骨颈骨折手术中应用腰骶丛神经阻滞复合小剂量丙泊酚的有效性。方法 随机选取2022年2月—2024年2月福州市第二总医院接诊的100例老年股骨颈骨折手术患者为研究对象,根据不同麻醉方法进行分组,每组50例,对照组给予静脉全身麻醉,研究组给予腰骶丛神经阻滞复合小剂量丙泊酚,比较两组警觉/镇静评分、平均动脉压、心率、并发症发生率。结果 研究组术中安装假体时、术后30 min的警觉/镇静评分均低于对照组,差异均有统计学意义(P均<0.05)。术中安装假体时和术后30 min,研究组的平均动脉压、心率均相比于对照组较高,差异均有统计学意义(P均<0.05)。关于恶心、呕吐、躁动、苏醒延迟等并发症的发生情况,研究组较为理想,其总发生率为18.00%(2/50),较对照组的4.00%(9/50)更低,差异有统计学意义(χ^(2)=5.005,P=0.025)。结论 在老年股骨颈骨折手术的麻醉过程中,选择腰骶丛神经阻滞复合小剂量丙泊酚为患者进行麻醉的效果好,能够改善警觉/镇静评分,稳定平均动脉压和心率,可以更好地降低术后的并发症。Objective To investigate the curative effect of low dose propofol and lumbosacral plexus block for aged pa⁃tients with femoral neck fracture.Methods From February 2022 to February 2024,100 elderly patients with femoral neck fracture treated in Fuzhou Second General Hospital were randomly selected as the research objects.They were divided into groups according to different anesthesia methods,50 cases in each group.The control group was given in⁃travenous general anesthesia.The study group was given lumbosacral plexus block combined with low dose propofol.The alertness/sedation score,mean arterial pressure,heart rate and complication rate were compared between the two groups.Results The alertness/sedation scores of the study group were lower than those of the control group at the time of prosthesis installation and 30 min after operation,and the differences were statistically significant(all P<0.05).When the prosthesis was installed during the operation and 30 min after the operation,the mean arterial pressure and heart rate of the study group were higher than those of the control group,and the differences were statistically signifi⁃cant(all P<0.05).Regarding the occurrence of complications such as nausea,vomiting,agitation,and delayed recov⁃ery,the study group was ideal,with a total incidence of 18.00%(2/50),which was lower than 4.00%(9/50)in the con⁃trol group,and the difference was statistically significant(χ^(2)=5.005,P=0.025).Conclusion In the operation of elderly femoral neck fracture,lumbosacral plexus block combined with low dose propofol has good anesthetic effect,can im⁃prove alertness/sedation score,stabilize mean arterial pressure and heart rate,and can better reduce postoperative complications.

关 键 词：老年股骨颈骨折 腰骶丛神经阻滞 小剂量丙泊酚 

分 类 号：R614[医药卫生—麻醉学]