超声引导神经刺激仪辅助腰丛-坐骨神经阻滞麻醉在老年髋关节置换术中的应用效果

Application effect of ultrasound-guided nerve stimulator assisted lumbar plexus-sciatic nerve block anesthesia in elderly hip replacement

目的分析超声引导神经刺激仪辅助腰丛-坐骨神经阻滞麻醉在老年髋关节置换术中的应用效果。方法选取2019年1月至2021年1月我院收治的150例老年髋关节置换术患者作为研究对象,按照随机数字表法将其分为麻醉(1)组(75例,全身麻醉)和麻醉(2)组(75例,超声引导神经刺激仪辅助腰丛-坐骨神经阻滞麻醉)。比较两组的麻醉效果。结果麻醉前,两组的平均动脉压(MAP)、心率(HR)比较,差异无统计学意义(P>0.05);切皮时、手术结束时,两组的MAP、HR低于麻醉前,差异具有统计学意义(P<0.05);切皮时、手术结束时,麻醉(2)组的MAP、HR高于麻醉(1)组,差异具有统计学意义(P<0.05)。麻醉(2)组的麻醉后30 min Richmond躁动镇静量表(RASS)、术后24 h简明-麦-吉疼痛问卷(SF-MPQ)评分低于麻醉(1)组,麻醉起效时间、意识恢复时间短于麻醉(1)组,痛觉恢复时间长于麻醉(1)组,差异具有统计学意义(P<0.05)。麻醉前、术后24 h,两组的简易智力状态检查量表(MMSE)评分比较,差异无统计学意义(P>0.05);术后2、12 h,麻醉(2)组的MMSE评分高于麻醉(1)组,差异具有统计学意义(P<0.05)。麻醉(2)组的不良反应总发生率低于麻醉(1)组,差异具有统计学意义(P<0.05)。结论超声引导神经刺激仪辅助腰丛-坐骨神经阻滞麻醉在老年髋关节置换术中的效果显著,有利于恢复认知功能,且安全性高。

Objective To analyze the application effect of ultrasound-guided nerve stimulator assisted lumbar plexus-sciatic nerve block anesthesia in elderly hip replacement.Methods A total of 150 elderly patients with hip replacement admitted in our hospital from January 2019 to January 2021 were selected as the research objects.According to the random number table method,the patients were divided into anesthesia group(1)(75 cases,general anesthesia)and anesthesia group(2)(75 cases,ultrasound-guided nerve stimulator assisted lumbar plexus-sciatic nerve block anesthesia).The anesthetic effects of the two groups were compared.Results Before anesthesia,there were no significant differences in mean arterial pressure(MAP),heart rate(HR)between the two groups(P>0.05);at the time of skin incision and at the end of operation,the MAP,HR of the two groups were lower than those before anesthesia,the differences were statistically significant(P<0.05);at the time of skin incision and at the end of operation,the MAP,HR in the anesthesia group(2)were higher than those in the anesthesia group(1),the differences were statistically significant(P<0.05).The scores of Richmond Agitation-Sedation Scale(RASS)at 30 min after anesthesia and the Short-Form of McGill Pain Questionnaire(SF-MPQ)at24 h after operation in the anesthesia group(2)were lower than those in the anesthesia group(1),the onset time of anesthesia and recovery time of consciousness were shorter than those in the anesthesia group(1),the recovery time of pain was longer than that in the anesthesia group(1),and the differences were statistically significant(P<0.05).Before anesthesia and 24 h after operation,there was no significant difference in Mini-mental State Examination(MMSE)score between the two groups(P>0.05);at 2,12 h after operation,the MMSE score of the anesthesia group(2)was higher than that of the anesthesia group(1),and the difference was statistically significant(P<0.05).The total incidence of adverse reactions in the anesthesia group(2)was lower than that in the anesthesia group(1),and the difference was statistically significant(P<0.05).Conclusion Ultrasound-guided nerve stimulator assisted lumbar plexus-sciatic nerve block anesthesia has a significant effect in elderly hip replacement,it is conducive to the recovery of cognitive function,and has high safety.