超声下腰骶丛神经阻滞在老年THA术中的应用

Application of ultrasonic lumbosacral plexus block in elderly patients with THA

目的探讨超声下腰骶丛神经阻滞在老年髋关节置换术中的应用效果.方法将60例择期行髋关节置换术老年患者按照随机数字表法分为实验组与对照组各30例.两组均给予喉罩全身麻醉,实验组联合超声下腰骶丛神经阻滞.比较两组患者术后不同时点视觉模拟评分法评分,比较两组患者阻滞持续时间、麻醉起效时间、拔管时间及下床活动时间.比较两组患者麻醉前、麻醉后15min、麻醉后30min、出室前的舒张压、收缩压及心率.结果实验组术后2h、4h、8h及12h视觉模拟评分法评分均显著低于对照组(P<0.01),阻滞持续时间、麻醉起效时间、拔管时间及下床活动时间均显著短于对照组(P<0.01).麻醉后15min、麻醉后30min及出室前两组舒张压、收缩压及心率水平均显著低于麻醉前(P<0.05),实验组显著高于对照组(P<0.05).结论喉罩全身麻醉联合超声下腰骶丛神经阻滞能够降低老年患者的手术疼痛感,麻醉效果好,对血压及心率影响较小,值得进一步推广.

Objective To investigate the application effect of ultrasonic lumbosacral plexus block in elderly patients with THA.Methods 60 elderly patients undergoing THA were divided into the experimental group and control group by random num ber method,30 cases in each group.The two group were all given laryngeal mask general anesthesia,and the experimental group underw ent ultrasoniclum bosacral plexus nerve block and laryngeal mask general anesthesia.The visual analogue scale scores of the two groups were compared at different time af ter operation.The duration of block,the onset time of anesthesia,the time of extubation and the time of getting out of bed were co mpared between the two groups.The diastolic blood pressure,systolic blood pressure and heart rate before anesthesia,15 min after anesthesia,30 min after anesthesia,and before leaving the room of the two groups were compared.Results The VAS scores of the experimental group at 2h,4h,8h and 12h af ter operation were significantly lower than those of the control group (P<0.05).The duration of block,anesthetic onset time,extubation time,and time of getting out of bed in the experimental group were all significantly shorter than those in the control group (P<0.05).The diastolic blood pressure,systolic blood pressure and heart rate levels at 15 min after anesthesia,30 min af ter anesthesia were significantly lower than those before anesthesia ( P<0.05 ),the experimental group was significantly higher than the control group (P<0.05).Conclusion Laryngeal mask general anesthesia com bined with ultrasonic lum bosacral plexus block can reduce the pain of surgery in elderly patients,the anesthetic effect is good,the impact on blood pressure and heart rate is small,it is worth further promotion.