超声引导下腰丛联合坐骨神经阻滞麻醉用于老年下肢骨科手术的效果

Effect of Ultrasound-guided Lumbar Plexus Combined with Sciatica Block Anesthesia on Orthopaedic Surgery of Lower Extremity in the Elderly

目的探析在老年下肢骨科手术中应用超声引导下腰丛联合坐骨神经阻滞麻醉的临床效果。方法从2017年3月至2019年3月择取我院收治的60例老年下肢骨科手术患者,按照入院时间将其分成对照组和研究组,对照组30例患者行以神经刺激器引导下腰丛联合坐骨神经阻滞,研究组30例患者行以超声引导下腰丛联合坐骨神经阻滞麻醉,对照分析两组临床效果。结果经对照分析,从麻醉效果上来看,研究组总有效率为96.67%,对照组总有效率为76.67%,研究组总有效率明显高于对照组,P<0.05;麻醉穿刺前,两组平均动脉压对比无统计学差异,麻醉后10 min、手术开始时、手术结束时,研究组平均动脉压均高于对照组,P<0.05;研究组疼痛评分为(0.83±0.15)分,对照组疼痛评分为(1.12±0.33)分,研究组疼痛评分明显低于对照组,P<0.05。结论对于老年下肢骨科手术患者来说,超声引导下腰丛联合坐骨神经阻滞麻醉的应用可以取得良好麻醉效果,同时不会对患者平均动脉压产生严重影响,可以减轻患者的疼痛反应,临床价值显著。

Objective To explore the clinical effect of ultrasound guided lumbar plexus combined with sciatic nerve block anesthesia in orthopaedic surgery of lower extremity in the elderly.Methods From March 2017 to March 2019,60 elderly patients undergoing lower extremity orthopaedic surgery were divided into control group and study group according to the admission time.30 patients in control group were anesthetized with ultrasound guided lumbar fasciculus combined with sciatica block,and 30 patients in control group were anesthetized with ultrasound guided lumbar plexus combined with sciatic nerve block.The clinical effects of the two groups were compared and analyzed.Results The total effective rate was 96.67%in the study group and 76.67%in the control group,and the total effective rate in the study group was significantly higher than that in the control group(P<0.05).Before anesthesia puncture,there was no significant difference in the average arterial pressure between the two groups.10 minutes after anesthesia,at the beginning of the operation and at the end of the operation,the average arterial pressure in the study group was higher than that in the control group(P<0.05).The pain score was(0.83±0.15)in the study group and(1.12±0.33)in the control group.The pain score in the study group was significantly lower than that in the control group(P<0.05).Conclusion For the elderly patients undergoing lower extremity orthopaedic surgery,the application of ultrasound-guided lumbar plexus combined with sciatic nerve block anesthesia can achieve good anesthetic effect,at the same time,it will not have a serious impact on the average arterial pressure of the patients,and can alleviate the pain response of the patients,and the clinical value is significant.