腰椎旁神经阻滞联合全麻对髋关节置换术患者血清COR、NE、E水平的影响

Effects of lumbar paravertebral nerve block combined with general anesthesia on serum COR,NE and E levels in patients undergoing hip replacement

目的探讨腰椎旁神经阻滞联合全麻对髋关节置换术(HR)患者血清皮质醇(COR)、去甲肾上腺素(NE)、肾上腺素(E)水平的影响。方法选取2017年1月~2018年12月本院HR患者100例,依据随机数字表法分为两组,每组50例,单麻组给予全麻,腰阻组在此基础上给予腰椎旁神经阻滞,比较两组的麻醉效果、应激反应和血流动力学。结果腰阻组麻醉后10min(T1)、髋关节置换时(T2)、术毕(T3)的COR、NE、E、MAP、HR明显低于单麻组,差异有统计学意义(P<0.05);腰阻组镇痛优良率明显高于单麻组,腰阻组全麻药物用量、不良反应率明显低于单麻组,差异有统计学意义(P<0.05)。结论腰椎旁神经阻滞联合全麻可有效改善HR患者应激反应、血流动力学,有利于提高患者的麻醉效果及减少药物不良反应。

Objective To explore effects of lumbar paravertebral nerve block combined with general anesthesia on serum cortisol(COR),norepinephrine(NE)and epinephrine(E)levels in patients undergoing hip replacement.Methods 100 patients who underwent HR in our hospital from January 2017 to December 2018 were selected.According to the random number table method,they were divided into two groups,with 50 cases in each group.The anesthesia alone group was given general anesthesia while the lumbar block group was given lumbar paravertebral nerve block on basis of it.Anesthetic effects,stress response and hemodynamics were compared between the two groups.Results The COR,NE,E,MAP and HR in the lumbar block group were significantly lower than those in the anesthesia alone group at 10 min after anesthesia(T1),at hip replacement(T2)and at the end of operation(T3),and the difference was statistically significant(P<0.05).The excellent and good rate of analgesia in lumbar block group was significantly higher than that in the anesthesia alone group.The general anesthetic dosage and adverse reaction rate in the lumbar block group were significantly lower than those in the anesthesia alone group,and the difference was statistically significant(P<0.05).Conclusion Paravertebral nerve block combined with general anesthesia can effectively improve the stress response and hemodynamics of HR patients.It is beneficial to improve the anesthetic effects and reduce adverse drug reactions.