摘要
目的 探讨全身麻醉联合超声引导下神经阻滞在骨科下肢急诊手术中的应用效果。方法 选择2021年2月至2024年12月合肥市第一人民医院收治的90例急诊骨科下肢手术患者为研究对象。根据随机数字表法,分为研究组(实施超声引导神经阻滞联合全身麻醉,45例)和对照组(实施全身麻醉,45例)。比较两组患者麻醉效果、血流动力学指标、术后疼痛程度、不良反应发生情况。结果 与对照组患者相比,研究组患者麻药瑞芬太尼和丙泊酚的用量明显更少(P<0.001),苏醒时间和拔管时间明显更短(P<0.001);研究组患者术后6h和术后24h的VAS评分明显更低(P<0.001);研究组患者不良反应总发生率明显更低(17.78%vs.4.44%,P<0.05)。T0时,两组患者心率、收缩压、舒张压均无明显差异(P>0.05);T1和T2时,研究组患者心率较对照组更慢(P<0.001),收缩压、舒张压明显更低(P<0.001)。结论 在急诊骨科下肢手术实施全身麻醉复合超声引导神经阻滞可明显减少精麻药品用量及缩短苏醒时间与拔管时间,血流动力学波动较小,可有效缓解患者术后疼痛,对患者机体造成的应激反应较轻微,麻醉效果较好。
Objective To investigate the eff ectiveness of general anesthesia combined with ultrasound-guided nerve block in emergency lower limb orthopedic surgeries.Methods A total of 90 patients undergoing emergency lower limb orthopedic surgeries at Zunyi First People's Hospital from February 2021 to December 2024 were enrolled in this study.The patients were randomly divided into the study group(45 cases receiving ultrasound-guided nerve block combined with general anesthesia)and the control group(45 cases receiving general anesthesia alone).Anesthesia eff ectiveness,hemodynamic parameters,postoperative pain levels,and the occurrence of adverse reactions were compared between the two groups.Results Compared with the control group,the study group had significantly lower doses of fentanyl and propofol(P<0.001),as well as significantly shorter recovery and extubation times(P<0.001).The study group also exhibited significantly lower Visual Analog Scale(VAS)scores at 6 hours and 24 hours postoperatively(P<0.001).The total incidence of adverse reactions in the study group was significantly lower than in the control group(4.44%vs.17.78%,P<0.05).At T0,there were no significant diff erences in heart rate,systolic pressure,or diastolic pressure between the two groups(P>0.05).However,at T1 and T2,the study group demonstrated slower heart rates(P<0.001)and significantly lower systolic and diastolic pressures compared to the control group(P<0.001).Conclusion The combination of general anesthesia and ultrasound-guided nerve block in emergency lower limb orthopedic surgeries significantly reduces the use of anesthetic agents,shortens recovery and extubation times,minimizes hemodynamic fluctuations,eff ectively alleviates postoperative pain,and results in a lighter physiological stress response,leading to better anesthetic outcomes.
作者
曹海
陈龙
冯典
CAO Hai;CHEN Long;FENG Dian(Department of Anesthesiology,Zunyi First People's Hospital(Third Affiliated Hospital of Zunyi Medical University),Zunyi 563000,China)
出处
《中华灾害救援医学》
2025年第5期606-609,共4页
Chinese Journal of Disaster Medicine
关键词
全身麻醉
神经阻滞
骨科
急诊手术
General anesthesia
Nerve block
Orthopedics
Emergency surgery
