摘要
目的探讨超声引导下髂筋膜间隙阻滞复合浅全麻在老年髋关节置换术中的麻醉效果及对术后恢复的影响。方法选取2019年3月至2020年3月于我院行髋关节置换术的106例老年患者,按照随机数字法分为对照组和观察组各53例,对照组给予单纯全身麻醉,观察组给予超声引导下髂筋膜间隙阻滞复合浅全麻。比较两组患者自主呼吸恢复时间、苏醒时间、下床活动时间、住院时间、疼痛程度(VAS)评分、髋关节功能(Harris)评分及不良反应发生率,并记录两组入室时(T0)、切片(T1)、扩髓腔(T2)、术毕时(T3)的血流动力学指标,术前、术毕和术后24 h的血糖(GLU)、乳酸(LAC)、皮质醇(Cor)水平变化。结果与对照组比较,观察组自主呼吸恢复时间、苏醒时间、下床活动时间及住院时间较短;术后6、12、24 h的VAS评分较低,T1、T2、T3时心率、平均动脉压较低,术毕和术后24 h GLU、LAC、Cor水平较低;出院时Harris评分较高;不良反应发生率较低,差异均有统计学意义(P<0.05)。结论超声引导下髂筋膜间隙阻滞复合浅全麻在老年髋关节置换术中的麻醉效果显著,可有效缓解疼痛程度,维持血流动力学平稳,降低应激水平,减少不良反应,促进髋关节功能恢复。
Objective To explore the anesthesia effect of ultrasound-guided fascia iliaca compartment block(FICB)combined with low general anesthesia in hip replacementsurgery and its influences on postoperative recovery in the elderly.Methods A total of 106 elderly patients who underwent hip replacement surgery in our hospital from March 2019 to March 2020 were enrolled.The patients were divided into control orobservation group by using random number table method,53 in each group.The control group was given general anesthesia while the observation group was given ultrasound-guided FICBcombined with low general anesthesia.The recovery time of spontaneous breathing,recovery time,out-of bed time,hospitalization time,scores of visual analogue scale(VAS)and hip function(Harris)and the incidence of adverse reactions were compared between the two groups.The changes in levels of hemodynamic indexes such as heart rate(HR)and mean arterial pressure(MAP)at time of entering the room(T0),slicing(T1),expanding medullary cavity(T2)andend of surgery(T3),and stress indexes estimated by using blood glucose(GLU),lactic acid(LAC)and cortisol(Cor)before surgery,at end of surgery and after 24 h of surgery were recorded.Results Compared with the control group,the observation group had shorter recovery time of spontaneous respiration,awakening time,activity time out of bed and hospitalization time.VAS scores were lower after 6,12,and 24 h of surgery,HR and MAP were lower at T1,T2 and T3,and Glu,Lac,and Cor levels were lower at the end of surgery and after 24 h of surgery in the observation group than those in the control group.However,Harris score was higher at discharge in the observation group than that in the control group.The incidence of adverse reactions in the observation groupwas lower than that in the control group.All differences between the two groups were statistically significant(P<0.05).Conclusion The anesthesia effects of ultrasound-guided FICB combined with low general anesthesia are significant in hip replacement surgery for the elderly.The technique can relieve the pain,maintain the hemodynamic stability,reduce the stress level and adverse reactions,and promote the recovery of hip function.
作者
聂亮
胡芸
曾丽
NIE Liang;HU Yun;ZENG Li(Department of Anesthesiology,Fushun People's Hospital,Zigong 643200,China)
出处
《实用医院临床杂志》
2021年第4期212-216,共5页
Practical Journal of Clinical Medicine
关键词
髋关节置换术
髂筋膜间隙阻滞复合浅全麻
超声
麻醉效果
血流动力学
应激指标
Hip replacement
Fascia iliaca compartment block combined with low general anesthesia
Ultrasound
Anesthesia effect
Hemodynamics
Stress index
