超声引导下腰丛联合坐骨神经阻滞麻醉在老年下肢骨科手术中的镇痛作用分析  

Analysis of Analgesic Effect of Ultrasound-guided Lumbar Plexus Combined with Sciatic Nerve Block Anesthesia in Lower Limb Orthopedic Surgery of Elderly

作　　者：林锡群 张铨 LIN Xiqun;ZHANG Quan(Putian 95th Hospital,Putian 351100,China;不详)

机构地区：[1]莆田九十五医院,福建莆田351100

出　　处：《中外医学研究》2025年第10期42-46,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探究超声引导下腰丛联合坐骨神经阻滞麻醉在老年下肢骨科手术中的镇痛效果。方法:选取2023年3月—2024年3月于莆田九十五医院行老年下肢骨科手术的112例患者进行前瞻性研究,采用随机数表法分为参照组与研究组,各56例。参照组实施全身麻醉,研究组在参照组基础上实施超声引导下腰丛联合坐骨神经阻滞麻醉,对比两组麻醉效果、不同时间疼痛介质水平及疼痛程度。结果:研究组感觉阻滞起效时间、运动阻滞起效时间、麻醉起效时间、定向力恢复时间、术后苏醒时间短于参照组,差异有统计学意义(P<0.05);麻醉后15 min、术后20 min,两组血清P物质(SP)、降钙素基因相关肽(CGRP)水平低于麻醉前,术后20 min的SP、CGRP水平高于麻醉后15 min,研究组麻醉后15 min、术后20 min的SP、CGRP水平低于参照组,差异有统计学意义(P<0.05);研究组术后2 h、6 h、12 h、24 h视觉模拟评分法(VAS)评分低于参照组,差异有统计学意义(P<0.05)。结论:超声引导下腰丛联合坐骨神经阻滞麻醉提高了老年下肢骨科手术的麻醉效果,减轻了疼痛。Objective:To explore the analgesic effect of ultrasound-guided lumbar plexus combined with sciatic nerve block anesthesia in lower limb orthopedic surgery of elderly.Method:A prospective study was conducted on 112 elderly patients who underwent lower limb orthopedic surgery in Putian 95th Hospital from March 2023 to March 2024,they were divided into the reference group and the study group by random number table method,56 cases in each group.The reference group was given general anesthesia,and the study group was given ultrasound-guided lumbar plexus combined with sciatic nerve block anesthesia on the basis of the reference group.The anesthetic effect,pain mediators level and pain degree at different times were compared between two groups.Result:The time of sensory block onset,motor block onset,anesthesia onset,directional force recovery and postoperative recovery in the study group were shorter than those of the reference group,the differences were statistically significant(P<0.05);at 15 min after anesthesia and 20 min after operation,the levels of serum substance P(SP)and calcitonin gene-related peptide(CGRP)in two groups were lower than those before anesthesia,and the levels of SP and CGRP at 20 min after operation were higher than those at 15 min after anesthesia,the levels of SP and CGRP in the study group at 15 min after anesthesia and 20 min after operation were lower than those in the reference group,and the differences were statistically significant(P<0.05);the visual analogue scale(VAS)scores in the study group at 2 h,6 h,12 h and 24 h were lower than those of the reference group,the differences were statistically significant(P<0.05).Conclusion:Ultrasound-guided lumbar plexus combined with sciatic nerve block anesthesia improves the anesthetic effect of lower extremity orthopedic surgery in elderly and reduces pain.

关 键 词：老年 下肢骨科手术 超声 腰丛神经阻滞 坐骨神经阻滞 镇痛 

分 类 号：R614[医药卫生—麻醉学]