轻比重罗哌卡因腰麻与超声引导下神经阻滞麻醉在老年髋部骨折手术中的应用效果对比

Comparison of the effect of light weight ropivacaine lumbar anesthesia an d ultrasound-guided nerve block anesthesia in the operation of elderly hip fracture

目的:比较轻比重罗哌卡因蛛网膜下腔阻滞麻醉(腰麻)与超声引导下神经阻滞麻醉在老年髋部骨折手术中的应用效果。方法:选取近年来在宁武县医疗集团人民医院进行髋部骨折手术的80例老年患者作为研究对象。随机将其分为腰麻组和比较组。术中用轻比重的罗哌卡因对腰麻组患者进行腰麻,对比较组患者进行超声引导下神经阻滞麻醉,然后比较两组患者麻醉的效果及各项临床指标。结果:腰麻组患者感觉阻滞起效的时间、运动阻滞起效的时间、感觉阻滞持续的时间和运动阻滞持续的时间均短于比较组患者,P<0.05。麻醉后10 min、30 min及60 min,腰麻组患者的心率(HR)均高于比较组患者,P<0.05。腰麻组患者麻醉效果的优良率高于比较组患者,其麻醉不良反应的发生率低于比较组患者,P<0.05。结论:与对接受髋部骨折手术的老年患者进行超声引导下神经阻滞麻醉相比,采用轻比重的罗哌卡因对其进行腰麻的效果更好,能更有效地缩短其感觉阻滞、运动阻滞起效的时间和维持的时间,提高其麻醉的效果,维持其术中生命体征的平稳,降低其麻醉不良反应的发生率。

Objective:To compare the effect of light weight ropivacaine subarachnoid block anesthesia(lumbar anesthesia)and ultrason-guided nerve block anesthesia in the operation of elderly hip fracture.Methods:80 elderly patients who underwent hip fracture operation in Ningwu County Medical Group people’s Hospital in recent years were selected as the research object.They were randomly divided into lumbar anesthesia group and comparison group.Patients in the lumbar anesthesia group were anesthetized with light weight ropivacaine,and patients in the comparison group were anesthetized with ultrasound-guided nerve block anesthesia,and then the anesthesia effect and clinical indicators of the two groups were compared.Results:The onset time of sensory block,the onset time of motor block,the duration time of sensory block and the duration time of motor block in lumbar anesthesia group were shorter than those in comparison group,P<0.05.The heart rate(HR)in lumbar anesthesia group was higher than that in comparison group at 10 min,30 min and 60 min after anesthesia,P<0.05.The excellent and good rate of anesthesia effect in lumbar anesthesia group was higher than that in comparison group,and the incidence of adverse anesthesia reaction was lower than that in comparison group,P<0.05.Conclusion:And for elderly patients with hip fracture surgery compared with ultrasound guided nerve block anesthesia,with light weight of pp because of the effect of lumbar hemp is better,to shorten their feelings more effectively block,motor block working time and keep time,improve the anesthesia effect,to maintain its smooth intraoperative vital signs,reduce its the incidence of adverse reactions in anesthesia.