全麻复合周围神经阻滞在全髋关节置换术中的麻醉效果及对应激反应的影响

Anesthetic effect of general anesthesia combined with peripheral nerve block in total hip arthroplasty and its impact on stress response

目的研究全麻复合周围神经阻滞在全髋关节置换术中的麻醉效果及对应激反应的影响。方法选取我院2016年3月至2018年3月收治的全髋关节置换术患者52例,随机将其分为对照组与研究组,各26例。手术过程中,对照组给予常规全身麻醉,研究组给予全麻复合周围神经阻滞麻醉。比较两组麻醉效果。结果术中10、30 min、术毕、术后10 min,研究组的心率(HR)、平均动脉压(MAP)及血氧饱和度(SpO2)均显著优于对照组(P<0.05);研究组术后24 h的镇痛效果优于对照组(P<0.05);术后10 min,研究组血清皮质醇(COR)、静脉血浆血糖(GLU)和白介素-6(IL-6)水平均显著优于对照组(P<0.05)。结论全髋关节置换术患者行全麻复合周围神经阻滞的麻醉效果较好,患者的应激反应更轻微,镇痛效果更理想,值得临床推广应用。

Objective To study the anesthetic effect of general anesthesia combined with peripheral nerve block in total hip arthroplasty and its impact on stress response. Methods A total of 52 patients who underwent total hip arthroplasty in our hospital from March 2016 to March 2018 were selected and randomly divided into control group and study group, with 26 cases in each group. During the operation, the control group was given general anesthesia, and the study group was given general anesthesia combined with peripheral nerve block anesthesia. The anesthetic effects of the two groups were compared. Results At 10, 30 min during operation, immediately after operation and 10 min after operation, the heart rate (HR), mean arterial pressure (MAP) and oxygen saturation (SpO2) in the study group were significantly better than those in the control group (P<0.05);the analgesic effect of 24 hours after operation in the study group was significantly better than that in the control group (P<0.05);at 10 min after operation, the levels of serum cortisol (COR), venous plasma glucose (GLU) and interleukin-6 (IL-6) in the study group were significantly better than those in the control group (P<0.05). Conclusion The general anesthesia combined with peripheral nerve block in patients with total hip replacement has better anesthesia effect, slighter levels of stress response in patients and better analgesic effect, which is worthy of clinical promotion and application.