超声引导下腰丛-坐骨神经阻滞麻醉在高龄患者半髋关节置换术中的应用效果分析

Effect of ultrasound-guided lumbar plexus-sciatic nerve block anesthesia in semi-hip arthroplasty in elderly patients

目的研究高龄半髋关节置换术患者在手术期间采用超声引导下腰丛-坐骨神经阻滞麻醉的临床价值。方法选择2016年10月至2018年10月本院接受半髋关节置换术治疗的102例高龄患者,通过随机分组的方式分成对照组和研究组,各51例。对照组实施常规全身麻醉;研究组实施超声引导下腰丛-坐骨神经阻滞麻醉。结果研究组麻醉原因导致的不良反应仅有3例少于对照组的10例;术后完全苏醒时间和术后住院时间短于对照组;麻醉后不同时间点的心率和平均动脉压的变化幅度小于对照组;麻醉总有效率达到96.1%,高于对照组的82.4%,组间比较差异有统计学意义(P<0.05)。结论半髋关节置换术患者在手术期间采用超声引导下腰丛-坐骨神经阻滞麻醉,可以减少麻醉不良反应,缩短苏醒时间和术后住院时间,基本不会对血压和心率造成影响,可以使麻醉总有效率得到显著提升。

Objective To study the clinical value of ultrasound-guided lumbar plexus-sciatic nerve block anesthesia in elderly patients undergoing hip arthroplasty.Methods 102 elderly patients who received hemihip replacement in our hospital from October 2016 to October 2018 were randomly divided into control group and study group,with 51 cases in each group.The control group underwent routine general anesthesia,the study group underwent ultrasound-guided lumbar plexus-sciatic nerve block anesthesia.Results There were only 3 cases of adverse reactions caused by anesthesia in the study group,less than 10 cases in the control group.The time of complete recovery and postoperative hospital stay was shorter than that of the control group.The changes of heart rate and mean arterial pressure at different time points after anesthesia was smaller than the control group.The total effective rate of anesthesia reached 96.1%,which was higher than that of the control group(82.4%).The difference between groups was statistically significant(P<0.05).Conclusion Ultrasound-guided lumbar plexus-sciatic nerve block anesthesia during surgery can reduce anesthetic adverse reactions,shorten the recovery time and postoperative hospital stay,and basically do not affect blood pressure and heart rate.The efficiency has been significantly improved.