高位髂筋膜联合股神经阻滞复合全身麻醉在老年人工髋关节置换术患者中的应用

Application of High Iliac Fascia Combined with Femoral Nerve Block and General Anesthesia in Elderly Patients with Artificial Hip Replacement

目的探讨高位髂筋膜联合股神经阻滞复合全身麻醉在老年髋部骨折患者行人工髋关节置换术中的应用效果。方法将82例行人工髋关节置换术的老年髋部骨折患者按随机数字表法分为两组,每组各41例。对照组给予常规全身麻醉,观察组施行高位髂筋膜联合股神经阻滞复合全身麻醉,观察至患者苏醒,对比两组麻醉效果、疼痛程度及不良反应。结果观察组苏醒、拔管时间短于对照组,丙泊酚用量少于对照组,术后6、12、24 h的视觉模拟疼痛评估量表(VAS)评分均低于对照组(P<0.05);两组不良反应无统计学差异(P>0.05)。结论高位髂筋膜联合股神经阻滞复合全身麻醉能够减少人工髋关节置换术围术期丙泊酚用量,提高老年髋部骨折患者的苏醒质量,并能有效缓解术后疼痛,且无严重不良反应。

Objective This paper aims to investigate the effect of high iliac fascia combined with femoral nerve block and general anesthesia in elderly hip fracture patients with artificial hip replacement.Methods 82 elderly hip fracture patients who underwent artificial hip arthroplasty were divided into two groups according to a random number table,with 41 cases in each group.The control group was given conventional general anesthesia,and the observation group was given high iliac fascia combined with femoral nerve block and general anesthesia,and the patients were observed until recovery.The anesthesia effect,pain degree and adverse reactions of the two groups were compared.Results The time of recovery,extubation of the observation group was shorter than that of the control group,and the consumption of propofol was less than that of the control group,the scores of visual analogue pain assessment scale(VAS)at 6,12 and 24 h after operation were lower than those in the control group(P<0.05).There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion High iliac fascia combined with femoral nerve block and general anesthesia can reduce the perioperative amount of propofol during artificial hip replacement,improve the recovery quality of elderly patients with hip fracture,which can effectively relieve postoperative pain without serious adverse effects.