全麻联合外周神经阻滞对膝关节置换术后患者急慢性疼痛及血浆凝血因子X活性的影响

Effects of General Anesthesia with Tracheal Intubation Alone or Combined with Peripheral Nerve Block on Acute and Chronic Pain and Plasma Anti-x Factor Activity in Patients with Knee Joint Replacement

【目的】比较单纯气管插管全身麻醉(全麻)与全麻联合外周神经阻滞两种不同麻醉方式对膝关节置换术后患者急慢性疼痛及血浆凝血因子X活性的影响。【方法】选取本院进行膝关节置换术的150例患者,随机分为两组,每组各75例。对照组患者采用气管插管全麻,观察组采用气管插管全麻联合外周神经阻滞麻醉,比较两组患者麻醉起效时间、苏醒时间、血流动力学指标水平变化、术后疼痛情况及术后血浆凝血因子X活性的变化。【结果】观察组患者的术中苏醒时间明显低于对照组(P<0.05);对照组患者术后收缩压、舒张压、心率水平明显低于术前(P<0.05),而观察组患者血流动力学指标水平与术前相比较差异均无统计学意义(P>0.05);观察组患者术后6h视觉模拟疼痛(VAS)评分明显低于对照组患者(P<0.05);观察组术后10min、20min、60min的血浆凝血因子X活性均高于对照组(P<0.05)。【结论】气管插管全麻联合外周神经阻滞麻醉能明显降低患者术后疼痛反应,患者血流动力学稳定且血浆凝血因子X活性更高,麻醉效果优越。

【Objective】To explore the effects of two different anesthesias(simple tracheal intubation general anesthesia and general anesthesia combined with peripheral nerve block)on postoperative acute and chronic pain and plasma clotting factor X activity in patients undergoing knee arthroplasty.【Methods】A total of 150 patients undergoing knee arthroplasty in our hospital were randomly divided into two group,with 75 cases in each group.The control group only used tracheal intubation general anesthesia,while the observation group used tracheal intubation general anesthesia combined with peripheral nerve block anesthesia.The anesthesia onset time,recovery time,and hemodynamic index levels of the two groups,postoperative pain and changes in the activity of anticoagulant factor X activity in the body after surgery were compared between the two groups.【Results】Intraoperative recovery time of the observation group was significantly lower than that of the control group(P<0.05).The systolic blood pressure,diastolic blood pressure,and heart rate levels of the control group were significantly lower than those before the operation(P<0.05),while the hemodynamics of the observation group did not show difference before and after surgery;the difference was not statistically significant(P>0.05).The visual analog pain(VAS)score of the observation group was significantly lower than that of the control group at 6 hours after the operation(P<0.05).The observation group was The activities of anticoagulant factor X activity at 10 minutes,20 minutes,and 60 minutes after the operation was higher than those of the control group(P<0.05).【Conclusion】General anesthesia combined with peripheral nerve block anesthesia for tracheal intubation can significantly reduce the postoperative pain response of patients,with stable hemodynamics and higher activity of anticoagulant factor Xa.Thus the anesthesia effect is superior.