探讨神经刺激仪引导下神经阻滞麻醉在老年高危患者下肢骨折手术中的应用价值

To explore the application value of nerve block anesthesia guided by nerve stimulation instrument in lower limb fractures in elderly patients with high risk

目的研究分析神经刺激仪引导下神经阻滞麻醉在老年高危患者下肢骨折手术中的应用效果。方法回顾性分析本院于2015年7月~2017年2月收治的56例患者的病历资料,随机分为对照组和观察组,对照组患者采取椎管内麻醉方法,观察组患者采取神经刺激仪引导下神经阻滞麻醉方法,对比分析两组患者麻醉成功率和术后并发症发生率。结果 (1)观察组患者27例麻醉成功,麻醉成功率(96.4%)和对照组(92.9%)比较差异无统计学意义。(2)观察组患者术后并发症仅仅出现1例低血压,总并发症发生率为3.6%,对照组中出现了3例尿滞留,4例低血压,1例神经损伤,总并发症发生率为28.6%。观察组患者术后并发症发生率较低,两组间比较差异有统计学意义(P<0.05)。(3)观察组患者麻醉术后的VAS疼痛评分(21.5±9.8)分和对照组(26.2±11.4)分比较,差异有统计学意义(P<0.05)。结论神经刺激仪引导下神经阻滞麻醉在老年高危患者下肢骨折手术中麻醉成功率更高,并发症少,值得临床推广应用。

Objective To study the effect of nerve block anesthesia in the treatment of lower limb fractures in elderly patients with high risk.Methods The medical records of 56 patients admitted to our hospital from July 2015 to February 2017 were retrospectively analyzed.The patients were randomly divided into control group and observation group.The patients in the control group were treated with spinal anesthesia.The patients in the observation group Stimulated instrument under the guidance of nerve block anesthesia method,comparative analysis of the two groups of patients with anesthesia success rate and postoperative complications.Results①There were no significant differences in the success rate of anesthesia,the success rate of anesthesia(96.4%)and the control group(92.9%)in the observation group.②The incidence of postoperative complications was 3.6%in the control group,3 cases of urinary retention,4 cases of hypotension,1 case of nerve injury and total complication occurred in the control group Rate was 28.6%.The incidence of postoperative complications in the observation group was lower,compared with the two groups,statistically significant(P<0.05).③The VAS pain score(21.5±9.8)in the observation group was significantly lower than that in the control group(26.2±11.4),and the difference between the two groups was statistically significant(P<0.05).Conclusion The nerve anesthesia under the guidance of nerve stimulation is more successful in the operation of lower limb fractures in elderly patients with high risk,less complication and worthy of clinical application.