超声引导神经阻滞联合七氟烷在老年髋关节置换术的应用

Application of Ultrasound Guided Nerve Block Combined With Sevoflurane in the Elderly Hip Arthroplasty

目的研究超声引导下神经阻滞联合七氟烷吸入麻醉对髋关节置换术老年患者的镇痛及预后的影响。方法选择2015年1月—2017年4月我院接诊的60例髋关节置换术的患者进行研究。将所有患者按照随机数表法,随机均分为研究组和对照组。对照组患者给予七氟烷吸入麻醉处理,研究组患者给予声引导下神经阻滞联合七氟烷吸入麻醉。两组患者血流动力学的比较分析。同时对患者手术后6、24、48小时的视觉模拟评分法(Visual Analogue Scale,VAS评分)进行对比。结果研究组患者在T_1、T_3、T_5、T_6的平均动脉压(mean artery pressure,MAP)和心率(Heart beat,HR)低于对照组(P<0.05)。研究组患者在T4的MAP高于对照组(P<0.05);对照组患者的MAP与HR水平在T_1、T_3、T_5、T_6时均高于T_0时的水平(P<0.05);研究组患者手术后6、24、48小时的VAS评分低于对照组,差异有统计学意义(P<0.05)。结论超声引导下神经阻滞联合七氟烷吸入麻醉对髋关节置换术老年患者,可得到持久有效的镇痛效果,对患者血流动力学产生的影响较小。

Objective To study the effect of ultrasound guided nerveblock combined with sevofurane inhalation anesthesia on the pain andprognosis of the elderly patients undergoing hip replacement. Methods60 cases of hip replacement were selected from January 2015 to April2017 in our hospital, they were randomly divided into study group andcontrol group, the control group were treated with sevofurane inhalationanesthesia, the study group were given acoustic - guided nerve blockcombined with sevofurane inhalation anesthesia. hemodynamics in thetwo groups were comparative analyzed. At the same time, the 6, 24, 48hours visual analog score （VAS score, Visual Analogue Scale） afterthe operation of the patients was compared. Results The averagearterial pressure （MAP, mean artery pressure） and heart rate （HR,Heart beat） of patients in T1, T3, T5 and T6 （HR, Heart beat） werelower than those of the control group （P 〈 0.05）. The MAP node ofT4 in the study group was higher than that in the control group （P〈 0.05）. The level of MAP and HR in the control group was higher than that of T0 at the level of T1, T3, T5 and T6 （P 〈 0.05）. The 6, 24, 48 hour VAS scores of the patients in the study group were lower than those in the control group, and the difference was statistically significant （P 〈 0.05）. Conclusion Ultrasound guided nerve block combined with sevoflurane anesthesia can achieve sustained and effective analgesic effect in elderly patients undergoing hip replacement, and has little effect on hemodynamics.