摘要
目的探讨超声引导下腰丛复合坐骨神经阻滞(LPSB)麻醉对股骨骨折(FF)老年手术患者麻醉效果的影响。方法选取2022年10月至2024年9月江西省抚州市第一人民医院收治的86例FF患者作为研究对象,按照随机数字表法分为对照组及观察组,每组43例。对照组予以蛛网膜下腔-硬膜外联合麻醉(CSEA),观察组予以LPSB麻醉技术,比较两组患者麻醉效果、运动神经(MN)、感觉神经(SN)阻滞的起效及维持时间,比较两组患者术后2~24 h时的疼痛程度及入室时(T_(0))、切皮时(T_(1))、术毕时(T_(2))的生命体征。结果观察组麻醉优良率高于对照组,MN、SN维持时间长于对照组,起效时间短于对照组,各时间点疼痛评分低于对照组,差异有统计学意义(P<0.05)。T_(1)、T_(2)时,两组患者平均动脉压(MAP)、心率(HR)低于本组T_(0)时,观察组MAP、HR低于对照组,差异有统计学意义(P<0.05)。结论超声引导下LPSB麻醉应用于FF老年手术患者中,可提高麻醉效果,具有起效快、维持时间长等优势,利于减轻患者疼痛程度,减少手术期间生命体征波动。
Objective To explore the influence of ultrasound-guided lumbar plexus combined with sciatic nerve block(LPSB)anesthesia on the anesthetic effect of elderly patients undergoing femoral fracture(FF)surgery.Methods A total of 86 patients with FF admitted to the First People's Hospital of Fuzhou City from October 2022 to September 2024 were selected as the research objects,and they were divided into the control group and the observation group according to the random number table method,with 43 cases in each group.The control group was given combined spinal and epidural anesthesia(CSEA),while the observation group was given LPSB anesthesia technique.The anesthesia effect,the onset and maintenance time of motor nerve(MN)and sensory nerve(SN)blocks were compared between the two groups.The pain degree of the two groups of patients at 2 to 24 hours after the operation and the vital signs at the time of entering the room(T_(0)),at the time of skin incision(T_(1)),and at the end of the operation(T_(2))were compared.Results The excellent and good rate of anesthesia in the observation group was higher than that in the control group,the maintenance time of MN and SN were longer than those in the control group,the onset time was shorter than that in the control group,and the pain scores at each time point were lower than those in the control group,the differences were statistically significant(P<0.05).At T_(1) and T_(2),the mean arterial pressure(MAP)and heart rate(HR)of the two groups were lower than those at T_(0),the MAP and HR of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).Conclusion Ultrasound-guided LPSB anesthesia applied in elderly patients undergoing FF surgery can improve the anesthetic effect.It has the advantages of rapid onset and long maintenance time,which is conducive to reducing the pain degree of patients and decreasing the fluctuation of vital signs during the operation.
作者
黄勇飞
梅英俊
罗志勇
HUANG Yongfei;MEI Yingjun;LUO Zhiyong(Department of Anesthesiology,the First People's Hospital of Fuzhou City,Jiangxi Province,Fuzhou 344000,China)
出处
《中国当代医药》
2025年第25期90-94,共5页
China Modern Medicine
基金
江西省卫生健康委科技计划项目(202211472)。
关键词
股骨骨折
腰丛复合坐骨神经阻滞
超声
麻醉效果
Femoral fracture
Lumbar plexus combined with sciatic nerve block
Ultrasound
Anesthetic effect
