神经阻滞联合喉罩全身麻醉在老年髋部手术中的应用效果

Effect of nerve block combined with general anesthesia of laryngeal mask on elderly patients undergoing hip surgery

目的探讨神经阻滞联合喉罩全身麻醉在老年髋部手术中的应用效果。方法选择2017年9月至2020年9月在济源市人民医院行髋部手术的80例老年患者,随机分为对照组与研究组,每组40例。对照组麻醉方式为喉罩全身麻醉,研究组麻醉方式为神经阻滞联合喉罩全身麻醉,对比麻醉效果。结果(1)麻醉前、麻醉后对照组与研究组患者的收缩压、舒张压、心率、血氧饱和度指标比较,差异未见统计学意义(P>0.05)。手术30 min、手术中、术后结束时对照组与研究组患者收缩压、舒张压、心率、血氧饱和度指标比较,差异有统计学意义(P<0.05)。(2)麻醉后12 h、麻醉后48 h时对照组与研究组患者精神状况、谵妄评分比较,差异未见统计学意义(P>0.05)。麻醉后24 h时研究组患者精神状况评分高于对照组、谵妄评分低于对照组(P<0.05)。麻醉后12 h、麻醉后24 h、麻醉后48 h时研究组患者疼痛评分均低于对照组(P<0.05)。(3)研究组患者总不良反应发生率低于对照组(P<0.05)。结论神经阻滞联合喉罩全身麻醉在老年患者髋部手术中应用价值较高,有着气管刺激小、减轻疼痛、血流动力学稳定等优势。

Objective To analyze the effect of nerve block combined with laryngeal mask general anesthesia on elderly patients undergoing hip surgery.Methods Eighty elderly patients who underwent hip surgery in the People’s Hospital of Jiyuan from September 2017 to September 2020 were taken as the subjects of this study.According to the random grouping method,they were divided into two groups:the control group and the study group,with 40 patients in each group.The control group was given laryngeal mask general anesthesia,and the study group was given nerve block combined with laryngeal mask general anesthesia.The anesthesia effects were compared.Results(1)There was no significant difference in systolic blood pressure,diastolic blood pressure,heart rate or blood oxygen saturation between the control group and the study group before and after anesthesia(P>0.05).There were significant differences in systolic blood pressure,diastolic blood pressure,heart rate and blood oxygen saturation between the control group and the study group at 30 min after operation,during operation and at the end of operation(P<0.05).(2)At 12 h and 48 h after anesthesia,there was no significant difference in mental status or delirium score between the control group and the study group(P>0.05).At 24 hours after anesthesia,the mental status score of the study group was higher than that of the control group,and the delirium score of the study group was lower than that of the control group(P<0.05).At 12 h,24 h and 48 h after anesthesia,the pain scores of the study group were lower than that of the control group(P<0.05).(3)The incidence of total adverse reactions in the study group was lower than that in the control group(P<0.05).Conclusions Nerve block combined with laryngeal mask general anesthesia has high application value in hip surgery of elderly patients.It has the advantages of less tracheal stimulation,pain relief and stable hemodynamics.