全身麻醉联合区域神经阻滞技术在创伤胫腓骨骨折手术中的应用效果

Effect of general anesthesia combined with regional nerve block on the operation of traumatic tibiofibular fracture

目的探讨全身麻醉联合区域神经阻滞技术在创伤胫腓骨骨折手术中的应用效果。方法选取2017年9月至2019年8月在南阳市第二人民医院治疗的62例创伤胫腓骨骨折患者,根据随机数字表法分为两组。对照组31例进行全身麻醉;观察组31例在此基础上联合区域神经阻滞。比较两组患者的一般麻醉指标,于拔管后15 min评价患者的睡眠障碍镇静评分标准(Ramsay评分)镇静评分,于拔管后30 min评价患者的视觉模拟评分法(VAS)疼痛评分。比较两组患者的并发症情况。结果观察组丙泊酚用量、术中输液量明显低于对照组,苏醒时间、拔管时间明显短于对照组(P<0.05);拔管后,观察组患者的Ramsay评分与VAS评分均明显低于对照组(P<0.05);观察组患者并发症率为6.45%(2/31),低于对照组[25.81%(8/31)],差异有统计学意义(P<0.05)。结论区域神经阻滞技术具有优越的镇静、镇痛效果,与全麻联合应用的效果更佳,且安全性良好,值得推广。

Objective To investigate the clinical value of general anesthesia combined with regional nerve block technique during the operation of patients with traumatic tibiofibular fracture.Methods Sixty-two patients with traumatic tibiofibular fractures who were treated in the Second People’s Hospital of Nanyang from September to September 2019 were divided into two groups.In the control group,31 patients underwent general anesthesia;in the observation group,31 patients were combined with regional nerve block technique.The general anesthesia indexes of the two groups were compared.The sedation score of sleep disturbance(Ramsay score)was evaluated 15 minutes after extubation,and the pain score of VAS was evaluated 30 minutes after extubation.The complications of the two groups were compared.Results The amount of propofol and intraoperative fluid in the observation group were significantly lower than those in the control group(P<0.05).The recovery time and extubation time were significantly shorter than those in the control group(P<0.05).After extubation,the Ramsay score and VAS score in the observation group were significantly lower than those in the control group(P<0.05).The complication rate of the observation group was 6.45%(2/31),which was lower than that of the control group(25.81%,8/31),the difference was significant(P<0.05).Conclusions The regional nerve block technique has superior sedative and analgesic effects,and the combined effect with general anesthesia is better,and the safety is good,which is worth promoting.