摘要
目的 观察超声引导竖脊肌联合横突下阻滞与硬膜外麻醉在老年患者椎体成形术中的应用效果。方法 选取2023年7月-2024年7月上饶市广信区人民医院行椎体成形术治疗的80例老年患者作为研究对象,按照随机数字表法将其分为对照组和试验组,每组40例。对照组应用连续硬膜外麻醉,试验组应用超声引导竖脊肌联合横突下阻滞。比较两组麻醉相关指标(麻醉起效时间、首次步行时间、首次步行距离、住院时长、24 h镇痛补救次数、24 h镇痛用药)、生命体征(收缩压、舒张压、心率)、疼痛程度、不良反应发生率。结果 试验组首次步行时间、首次步行距离与对照组无差异(P>0.05),而麻醉起效时间、住院时长、24 h镇痛补救次数、24 h镇痛用药量均低于对照组(P<0.05);试验组T1~T3时间点内各项生命体征指标波动均小于对照组(P<0.05);试验组术后6、8、10、12、24 h的静态VAS评分以及动态VAS评分均低于对照组(P<0.05);试验组不良反应发生率(2.50%)低于对照组(17.50%)(P<0.05)。结论 超声引导竖脊肌联合横突下阻滞在老年患者椎体成形术中的效果确切,患者麻醉起效更快,术中生命体征平稳、疼痛程度减轻,24 h镇痛补救次数及用药量少,有助于患者快速康复,且安全性较高。
Objective To observe the application effect of ultrasound-guided erector spinae combined with subtransverse block and epidural anesthesia for vertebroplasty in elderly patients.Methods A total of 80 elderly patients who underwent vertebroplasty in the Shangrao Guangxin District People′s Hospital from July 2023 to July 2024 were selected as the research objects.According to the random number table method,they were divided into control group and experimental group,with 40 patients in each group.The control group was treated with continuous epidural anesthesia,and the experimental group was treated with ultrasound-guided erector spinae combined with subtransverse block.The anesthesia-related indicators(anesthesia onset time,first walking time,first walking distance,length of hospitalization,number of 24-hour analgesic remedies,24-hour analgesic medication),vital signs(systolic blood pressure,diastolic blood pressure,heart rate),degree of pain,and incidence of adverse reactions were compared between the two groups.Results No significant differences were observed between the experimental and control groups regarding the first walking time and the first walking distance(P>0.05),while the anesthesia onset time,length of hospitalization,the number of 24-hour analgesic remedies,and 24-hour analgesic medication were lower than those in the control group(P<0.05).The fluctuation of vital signs in the experimental group was less than that in the control group at T1-T3 time points(P<0.05).The static VAS score and dynamic VAS score of the experimental group at 6,8,10,12 and 24 h after operation were lower than those of the control group(P<0.05).The incidence of adverse reactions in the experimental group(2.50%)was lower than that in the control group(17.50%)(P<0.05).Conclusion Ultrasound-guided erector spinae combined with subtransverse block has a definite effect in vertebroplasty in elderly patients.The patient′s anesthesia takes effect faster,the intraoperative vital signs are stable,the degree of pain is reduced,and the number of analgesic remedies within 24 hours and the dosage are less.It is helpful for patients to recover quickly and has high safety.
作者
谢赐
邓笔生
汪雅
XIE Ci;DENG Bisheng;WANG Ya(Department of Anesthesiology,Shangrao Guangxin District People′s Hospital,Shangrao 334100,Jiangxi,China)
出处
《医学信息》
2025年第20期115-118,共4页
Journal of Medical Information
基金
江西省卫生健康委科技计划项目(编号:202410974)。
关键词
超声引导竖脊肌联合横突下阻滞
硬膜外麻醉
椎体成形术
生命体征
Ultrasound-guided erector spinae combined with subtransverse block
Epidural anesthesia
Vertebroplasty
Vital signs
