超声引导下髂筋膜阻滞复合喉罩全麻在股骨干骨折手术患者中的应用

Application of Ultrasound-Guided Fascia Iliaca Block Combined with Laryngeal Mask General Anesthesia in Patients with Femoral Shaft Fracture Surgery

目的:探讨超声引导下髂筋膜阻滞复合喉罩全麻在股骨干骨折手术患者中的应用效果。方法:选取2020年4月至2021年4月于医院行手术治疗的92例股骨干骨折患者,按随机数字表法分为对照组与观察组,各46例。对照组施以气管插管全身麻醉,观察组则应用超声引导下髂筋膜阻滞复合喉罩全麻。对比两组血流动力学、应激反应指标、术后恢复情况、不良反应发生情况。结果:麻醉前(T0),两组心率(HR)、舒张压(DBP)、收缩压(SBP)、皮质醇(Cor)、去甲肾上腺素(NE)、肾上腺素(E)水平对比,差异无统计学意义(P>0.05);麻醉10 min后(T1)、麻醉30 min后(T2)、术毕时(T3),观察组HR、DBP、SBP、Cor、NE、E水平均低于对照组,差异有统计学意义(P<0.05)。观察组苏醒时间、拔管时间均短于对照组,术后2 h视觉模拟量表(VAS)评分低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生情况比较,差异无统计学意义(P>0.05)。结论:超声引导下髂筋膜阻滞复合喉罩全麻在股骨干骨折手术患者中效果确切,可有效稳定患者术中血流动力学,减轻机体应激反应及术后疼痛,促进术后苏醒,且不会增加不良反应。

Objective:To investigate the application effect of ultrasound-guided fascia iliaca block combined with laryngeal mask general anesthesia in patients with femoral shaft fracture surgery.Methods:A total of 92 patients with femoral shaft fractures who underwent surgical treatment in our hospital from April 2020 to April 2021 were selected and divided into control group and observation group according to the random number table method,with 46 cases in each group.The control group was given general anesthesia with endotracheal intubation,while the observation group was given general anesthesia with ultrasound-guided iliac fascia block combined with laryngeal mask.The hemodynamics,stress response indicators,postoperative recovery and adverse reactions were compared between the two groups.Results:Before anesthesia(T0),the levels of heart rate(HR),diastolic blood pressure(DBP),systolic blood pressure(SBP),cortisol(Cor),norepinephrine(NE),and epinephrine(E)were compared between the two groups,there was no statistical difference(P>0.05);the levels of HR,DBP,SBP,Cor,NE,and E in the observation group were lower than those in the control group after 10 minutes of anesthesia(T1),30 minutes after anesthesia(T2),and at the end of the operation(T3),there was a statistical difference(P<0.05);the recovery time and extubation time of the observation group were shorter than those of the control group,and the visual analog scale(VAS)score 2 hours after the operation was lower than that of the control group,there was a statistical difference(P<0.05).Conclusion:Ultrasound-guided fascia iliaca block combined with laryngeal mask general anesthesia is effective in patients with femoral shaft fracture surgery.It can effectively stabilize the hemodynamics of patients during surgery,reduce the body's stress response and postoperative pain,and promote postoperative wake up,and will not increase adverse reactions.