超声引导下腰骶丛神经阻滞在股骨颈骨折手术患者中的应用

Application of Ultrasound-Guided Lumbosacral Plexus Block in Patients with Femoral Neck Fracture Surgery

目的探讨超声引导下腰骶丛神经阻滞(LPB)在股骨颈骨折(FNF)手术患者中的应用效果。方法选取2018年5月至2020年5月在淅川县人民医院治疗的84例FNF患者作为研究对象,采用随机数字表法分为两组,各42例。对照组接受常规气管插管全麻,观察组接受超声引导下LPB麻醉,比较两组麻醉前(T_(0))、麻醉后30 min(T_(1))、麻醉后1 h(T_(2))与术毕即刻(T_(3))的心率与平均动脉压,比较两组术后拔管或拔喉罩时间、苏醒时间与下床时间,比较两组术后并发症发生率。结果两组T_(1)时刻平均动脉压、心率均较T_(0)升高,观察组较对照组低,两组T_(2)、T_(3)时刻的平均动脉压、心率较T_(1)时刻逐渐降低,且观察组低于对照组;观察组拔喉罩与术后苏醒时间均较对照组短(P<0.05);两组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论 FNF患者行超声引导下LPB麻醉,可稳定术中与术后血流动力学,缩短拔喉罩时间与苏醒时间。

Objective To investigate the effect of ultrasound-guided lumbosacral plexus block(LPB)in patients with femoral neck fracture(FNF)surgery.Methods Eighty-four patients with femoral neck fracture treated in Xichuan County People’s Hospital from May 2018 to May 2020 were selected as the research subjects,a random number table method was used to divide them into two groups,with 42 cases in each group.The control group received general anesthesia with conventional endotracheal intubation,and the observation group received ultrasound-guided LPB.Heart rate and mean arterial pressure between the two groups were compared before anesthesia(T_(0)),30 minutes(T_(1)),1 hour(T_(2))and immediately after operation(T_(3)),the time of extubation or laryngeal mask removal,recovery time and getting out of bed were compared between the two groups,the incidence of postoperative complications was compared between the two groups.Results MAP and HR in both groups at T_(1)after anesthesia were increased than those at T_(0),and the observation group were lower in comparison with the control group,MAP and HR at T_(2)and T_(3)in both groups were gradually decreased than those at T_(1),and the observation group were lower in comparison with the control group(P<0.05).The laryngeal mask removal and postoperative recovery time in the observation group were shorter than those in the control group(P<0.05).There was no statistical difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion Ultrasound-guided lumbosacral plexus block anesthesia in patients with femoral neck fracture can stabilize intraoperative and postoperative hemodynamics and shorten laryngeal mask removal time and recovery time.