老年髋关节置换术中应用超声引导下神经阻滞复合全身麻醉的效果

Effect of Combined Ultrasound-guided Nerve Block and General Anesthesia in Elderly Hip Joint Replacement

目的分析老年髋关节置换术中应用超声引导下神经阻滞复合全身麻醉的效果。方法选取2015年1月—2019年7月在该院行老年髋关节置换术的患者中选取96例为研究对象,按照随机数字表法分为两组,对照组行常规静吸复合全麻气管插管,观察组行超声引导下神经阻滞复合喉罩全身麻醉,对比两组麻醉效果、不同时间点VAS(视觉模拟疼痛)评分以及不良反应发生情况。结果观察组苏醒时间、恢复室停留时间以及拔管时间分别为(5.16±0.28)min、(32.12±1.05)min、(12.02±1.28)min,均短于对照组(t=8.203、9.634、12.633,P<0.05);观察组术后2 h、术后6 h、术后12 h以及术后24 h时的VAS评分分别为(1.92±0.25)分、(1.56±0.52)分、(1.12±0.35)分、(0.72±0.09)分,均低于对照组(t=9.633、12.633、9.633、8.126,P<0.05);观察组不良反应发生率为6.25%,低于对照组的27.08%(χ2=7.500,P<0.05)。结论老年髋关节置换术中应用超声引导下神经阻滞复合全身麻醉的效果理想,能有效镇痛,且安全性高。

Objective To analyze the effect of combined ultrasound-guided nerve block and general anesthesia in hip replacement surgery in the elderly.Methods A total of 96 patients who underwent hip replacement surgery in the hospital from January 2015 to July 2019 were selected as research subjects.They were divided into two groups according to the random number table method.After intubation,the observation group underwent general anesthesia with nerve block combined with laryngeal mask under ultrasound guidance.The anesthesia effect,VAS(visual simulated pain)score at different time points and the occurrence of adverse reactions were compared between the two groups.Results The awake time,recovery room stay time,extubation timeand in the observation group were(5.16±0.28)min,(32.12±1.05)min,and(12.02±1.28)min,all shorter than those in the control group(t=8.203,9.634,12.633,P<0.05);VAS scores at 2 h,6 h,12 h,and 24 h after surgery in the observation group were(1.92±0.25)points,(1.56±0.52)points,(1.12±0.35)points,(0.72±0.09)points,all were lower than the control group(t=9.633,12.633,9.633,8.126,P<0.05);the incidence of adverse reactions in the observation group was 6.25%,which was lower than 27.08%in the control group(χ2=7.500,P<0.05).Conclusion Ultrasound-guided nerve block combined with general anesthesia for hip joint replacement in the elderly is effective,effective in analgesia,and highly safe.