摘要
目的探讨超声引导下腰方肌阻滞复合芬太尼静脉全麻对肾结石手术患者的应用效果。方法本研究为前瞻性随机对照试验,纳入信阳市第三人民医院2020年6月至2022年6月收治的92例肾结石患者,按照随机数字表法分为研究组(46例)和对照组(46例)。两组患者均接受经皮肾镜碎石取石术(PCNL)治疗,对照组接受芬太尼静脉全身麻醉,研究组接受超声引导下腰方肌阻滞复合芬太尼静脉全身麻醉。比较两组患者入室麻醉前(T_(1))、麻醉诱导后10 min(T_(2))、手术30 min时(T_(3))、术毕时(T_(4))的血流动力学[心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO_(2))],术后指标[视觉模拟评分(VAS)、舒芬太尼用量、患者自控镇痛(PCA)有效按压次数、排气时间、住院时间]、不良反应(苏醒期躁动、恶心呕吐、呼吸抑制、低血压)发生情况。结果两组患者T_(1)时HR、MAP及SpO_(2)比较,差异无统计学意义(P>0.05);两组患者T_(2)~T_(4)时HR、MAP及SpO_(2)呈先下降后上升的趋势,且研究组下降幅度小于对照组(P<0.05)。术后,研究组患者VAS评分低于对照组,舒芬太尼用量、PCA有效按压次数少于对照组,排气时间、住院时间短于对照组(P<0.05)。研究组患者不良反应总发生率低于对照组(P<0.05)。结论超声引导下腰方肌阻滞复合芬太尼静脉全麻能维持肾结石手术患者血流动力学稳定,安全性良好。
Objective To investigate the effect of ultrasound guided lumbar quadratus muscle block combined with fentanyl intravenous anesthesia in patients undergoing kidney stone surgery.Methods This study was a prospective randomized controlled trial,involving 92 patients with kidney stones admitted to the Third People’s Hospital of Xinyang from June 2020 to June 2022.They were randomly divided into a study group(46 cases)and a control group(46 cases)according to the random number table method.Both groups of patients received percutaneous nephrolithotomy(PCNL)treatment,the control group received fentanyl intravenous general anesthesia,while the study group received ultrasound guided lumbar muscle block combined with fentanyl intravenous general anesthesia.The hemodynamics[heart rate(HR),mean arterial pressure(MAP),oxygen saturation(SpO_(2))],postoperative indexes[visual analogue scale(VAS),sufentanil dosage,patients control analgesia(PCA)effective pressing times,exhaust time,hospitalization time]and adverse reactions(emergence agitation,nausea and vomiting,respiratory depression,hypotension)were compared between the two groups before anesthesia(T_(1)),10 minutes after anesthesia induction(T_(2)),30 minutes after operation(T_(3))and at the end of operation(T_(4)).Results There were no differences in HR,MAP,and SpO_(2)between the two groups of patients at T_(1)(P>0.05).At T_(2)~T_(4),HR,MAP,and SpO_(2)showed a trend of first decreasing and then increasing in both groups of patients,and the decrease in the study group was smaller than that in the control group(P<0.05).After operation,the VAS score of patients in the study group was lower than that in the control group,the amount of sufentanil and the number of effective PCA compressions were less than those in the control group,and the exhaust time and hospital stay were shorter than those in the control group(P<0.05).The total incidence of adverse reactions in the study group was lower than that in the control group(P<0.05).Conclusion Ultrasound guided lumbar quadratus muscle block combined with fentanyl intravenous anesthesia can maintain hemodynamic stability and good safety in patients undergoing kidney stone surgery.
作者
宋秀
SONG Xiu(Department of Anesthesiology,the Third People’s Hospital of Xinyang,Xinyang 464000,China)
出处
《河南医学研究》
CAS
2023年第21期3974-3977,共4页
Henan Medical Research
关键词
肾结石
超声引导
腰方肌阻滞
芬太尼
全身麻醉
血流动力学
kidney stones
ultrasound guidance
lumbar quadratus muscle block
fentanyl
general anesthesia
hemodynamics
