摘要
目的比较老年髋关节置换手术患者采取髂筋膜间隙阻滞(FICB)复合全身麻醉与腰硬联合麻醉(CSEA)的效果。方法抽取河南省洛阳正骨医院2021年7月至2022年7月收治的104例老年髋关节置换手术患者,按双色球法组分为对照组与观察组,每组52例。对照组采用CSEA方案麻醉,观察组采用FICB复合全身麻醉方案。比较两组手术及麻醉情况,比较两组手术前后平均动脉压(MAP)、心率(HR)、视觉模拟评分法(VAS)评分及匹兹堡睡眠质量指数(PSQI)评分,比较两组不良反应发生率。结果两组手术时间、手术出血量、输液量比较差异未见统计学意义(P>0.05),但观察组麻醉操作时间[(5.63±1.82)min]短于对照组[(17.52±4.30)min],P<0.05。术前及术后30 min,两组MAP、HR比较差异未见统计学意义(P>0.05);切皮后5 min及扩髓腔时,两组MAP、HR比较差异有统计学意义(P<0.05)。术前,两组VAS评分比较差异未见统计学意义(P>0.05);术后6、12、24 h,两组VAS评分均降低,且组间比较差异有统计学意义(P<0.05)。术前,两组PSQI评分比较差异未见统计学意义(P>0.05);术后1、3、5 d,观察组PSQI评分低于对照组(P<0.05)。两组不良反应发生率比较差异未见统计学意义(P>0.05)。结论与CSEA方案比较,老年髋关节置换手术患者采取FICB复合全身麻醉方案可提高麻醉效果,维持围术期MAP、HR稳定,术后镇痛作用更好,且术后患者的睡眠质量更好。
Objective To compare the effect of fascia iliaca compartment block(FICB)combined with general anesthesia versus combined spinal-epidural anesthesia(CSEA)in elderly patients undergoing hip replacement surgery.Methods A total of 104 elderly patients who underwent hip replacement surgery in Luoyang Orthopedic-Traumatological Hospital of Henan Province from July 2021 to July 2022 were selected,and they were divided into control group and observation group by the two-sphere method,with 52 cases in each group.The control group was given CSEA scheme anesthesia,while the observation group was given FICB combined general anesthesia scheme.The anesthetic effects of the two groups were compared.The preoperative and postoperative mean arterial pressure(MAP),heart rate(HR),visual analogue scale(VAS)score and Pittsburgh sleep quality index(PSQI)were compared between the two groups.And the incidence of adverse reactions of the two groups were compared.Results There was no significant difference in duration of operation,operation blood loss,infusion volume between the two groups(P>0.05);however,the anesthesia operation time in the observation group was(5.63±1.82)min,shorter than the(17.52±4.30)min in the control group(P<0.05).There was no significant difference in MAP and HR between the two groups before and 30 minutes after operation(P>0.05);there was a statistically significant difference in MAP and HR between the two groups 5 minutes after skin incision and at the time of pulp cavity expansion(P<0.05).There was no significant difference in VAS score between the two groups before operation(P>0.05);at 6,12 and 24 hours after operation,the VAS score in the two groups decreased,and the difference between the two groups was statistically significant(P<0.05).There was no statistically significant difference in PSQI score between the two groups before operation(P>0.05);1,3 and 5 days after operation,the PSQI scores of the observation group were lower than those of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions Compared with CSEA scheme,FICB combined general anesthesia scheme for elderly patients undergoing hip replacement surgery can improve the anesthesia effect,maintain the stability of perioperative MAP and HR,and bring better postoperative analgesic effect.Moreover,patients treated by this scheme have better sleep quality.
作者
王艳
Wang Yan(Department of Anesthesia and Perioperative Medicine,Luoyang Orthopedic-Traumatological Hospital of Henan Province,Henan Provincial Orthopedics Hospital,Luoyang 471000,China)
出处
《中国实用医刊》
2023年第5期38-41,共4页
Chinese Journal of Practical Medicine
关键词
髋关节
老年
置换手术
髂筋膜间隙阻滞
全身麻醉
腰硬联合麻醉
Hip joint
Elderly
Hip replacement surgery
Fascia iliaca compartment block
General anesthesia
Combined spinal-epidural anesthesia
作者简介
王艳,Email:wangyan801009@163.com。
