超声引导髂筋膜阻滞复合喉罩全身麻醉在高龄危重患者股骨头置换手术中的麻醉效果及价值  

Ultrasound-guided Iliac Fascia Block with Laryngeal Mask General Anesthesia in Bipolar Arthroplasty for Elderly Critically Patients

作　　者：吴旭[1] 伍玉哲[1] 高玉峰[1] 王雷[2] WU Xu;WU Yuzhe;GAO Yufeng;WANG Lei(Department of Anesthesia,Section One,Zhongshan Hospital Affiliated to Dalian University,Dalian 116001,Liaoning,China;Department of Orthopedics,the 967 Hospital of the PLA Joint Logistic Support Force,Dalian 116001,Liaoning,China)

机构地区：[1]大连大学附属中山医院麻醉一科,辽宁大连116001 [2]中国人民解放军联勤保障部队第九六七医院骨科,辽宁大连116001

出　　处：《系统医学》2025年第6期58-61,共4页Systems Medicine

摘　　要：目的研究超声引导髂筋膜阻滞复合喉罩全身麻醉在高龄危重患者股骨头置换手术(bipolar arthro-plasty,BA)的麻醉效果及价值。方法非随机选取2020年1月—2022年1月大连大学附属中山医院收治的90例需行股骨头置换手术高龄危重患者为研究对象。按不同麻醉方式分为对照组(常规单纯喉罩全身麻醉)与研究组(超声引导髂筋膜阻滞复合喉罩全身麻醉),各45例,对比两组患者不同时间血流动力学指标与疼痛水平差异。结果研究组在不同时间段心率、平均动脉压变化趋势稳定于对照组,差异有统计学意义(P均<0.05)。两组患者血氧饱和度各时期比较,差异无统计学意义(P均>0.05)。两组患者术后0.5 h及术后6 h时疼痛评分对比,差异无统计学意义(P均>0.05),而术后3 h时对照组疼痛评分为(4.08±1.13)分,高于研究组的(3.15±0.86)分,差异有统计学意义(t=4.393,P<0.05)。结论在喉罩全麻基础上联用超声引导的髂筋膜阻滞有利于维持高龄危重患者BA术中生命体征平稳,并减轻患者术后疼痛程度。Objective To investigate the efficacy and value of ultrasound-guided iliac fascia block combined with la-ryngeal mask general anesthesia in critical elderly patients undergoing bipolar arthroplasty(BA).Methods A total of ninety elderly critically ill patients who needed femoral head replacement admitted to Zhongshan Hospital Affiliated to Dalian University from January 2020 to January 2022 were non-randomly selected as the research objects.According to different anesthesia methods,they were divided into the control group(conventional laryngeal mask general anesthe-sia)and the study group(ultrasound-guided fascia iliaca block combined with laryngeal mask general anesthesia),with forty-five cases in each group.The differences in hemodynamic indexes and pain levels at different times were compared between the two groups.Results The changes of heart rate and mean arterial pressure in the study group were stable in the control group at different time points,and the differences were statistically significant(all P<0.05).There was no significant difference in blood oxygen saturation between the two groups at each time point(all P>0.05).There was no significant difference in pain score between the two groups at 0.5 h and 6 h after operation(both P>0.05),while the pain score of the control group was 4.08±1.13,which was higher than 3.15±0.86 of the study group at 3 h after operation,and the difference was statistically significant(t=4.393,P<0.05).Conclusion An additive ultrasonic-guided iliac fascia block can maintain the stability of vital signs and alleviate postoperative pain in criti-cally elderly patients receiving BA,indicating its potential for broader adoption.

关 键 词：髂筋膜阻滞 喉罩全身麻醉 股骨头置换手术 

分 类 号：R614[医药卫生—麻醉学]