超声引导髂筋膜间隙阻滞联合骶丛神经阻滞复合喉罩全麻在老年髋关节置换术中的应用

Application of ultrasound-guided iliac fascia compartment block and sacral plexus block combined with laryngeal mask general anesthesia in elderly patients undergoing hip replacement

目的探讨超声引导髂筋膜间隙阻滞联合骶丛神经阻滞复合喉罩全麻应用于老年髋关节置换术的效果。方法选用行髋关节置换术的老年患者60例,按随机数字表法分为腰硬联合麻醉组和超声引导髂筋膜间隙阻滞联合骶丛神经阻滞复合喉罩全麻组各30例。观察两组麻醉操作时间、术中去甲肾上腺素用量、术后呕吐率、首次下床时间、羟考酮用量及住院天数的差异。结果两组术中去甲肾上腺术用量、术后首次下床时间及羟考酮用量比较,差异有统计学意义(P<0.05),麻醉操作时间、术后呕吐率及住院天数比较,差异无统计学意义(P>0.05)。结论超声引导髂筋膜间隙阻滞联合骶丛神经阻滞复合喉罩全麻应用于老年髋关节置换术,术中呼吸循环稳定,术后阿片类药用量减少,有利于患者早期下床活动。

Objective To investigate the effect of ultrasound-guided iliac fascia block and sacral plexus block combined with laryngeal mask general anesthesia in elderly hip replacement.Methods Sixty elderly patients who underwent hip replacement were randomly divided into subarachnoid space combined with epidural anesthesia group and ultrasound-guided iliac fascial compartment block and sacral plexus nerve block combined with laryngeal mask general anesthesia group,30 in each group.The differences in anesthesia operation time,intraoperative norepinephrine dosage,postoperative vomiting rate,time of the patient's first postoperative out-of-bed activity,oxycodone dosage and postoperative hospitalization days were observed.Results There were statistically significant differences between the two groups in intraoperative norepinephrine dosage,postoperative first time out-of-bed and postoperative oxycodone dosage(P<0.05),but no statistically significant differences in anesthetic operation time,postoperative vomiting rate and postoperative hospitalization days(P>0.05).Conclusion In ultrasound-guided iliofascialcompartment block and sacral plexus nerve block combined with laryngeal mask general anesthesia for hip arthroplasty in the elderly,intraoperative respiratory circulation was stable,and postoperative opioid dosage was reduced.It is conducive to patients'early out-of-bed activities.