超声引导下腰丛神经+骶丛神经阻滞联合喉罩全身麻醉对老年全髋关节置换术麻醉效果的影响

Influence of ultrasound-guided lumbar plexus+sacral plexus block combined with laryngeal mask general anesthesia on the anesthetic effect of elderly total hip arthroplasty

目的:观察分析超声引导下腰丛神经+骶丛神经阻滞联合喉罩全身麻醉对老年全髋关节置换术(THA)的麻醉效果。方法:选择90例择期行单侧THA老年患者,根据麻醉方式不同分为观察组和对照组,每组各45例。对照组实施喉罩全身麻醉,观察组实施超声引导下腰丛神经+骶丛神经阻滞联合喉罩全身麻醉。比较两组围术期血流动力学指标变化、麻醉相关指标、麻醉效果、苏醒质量及术后并发症发生情况。结果:观察组T1、T6时刻HR、MAP均低于同期对照组(P<0.05);观察组麻醉用药总量、警觉/镇静评分及术后并发症总发生率均低于对照组;麻醉效果优率高于对照组;术后苏醒时间、拔喉罩时间均短于对照组,且两组组间上述指标比较,差异均有统计学意义(P<0.05)。结论:超声引导下腰丛神经联合骶丛神经阻滞联合喉罩全身麻醉可有效维持老年THA患者血流动力学稳定,利于提高麻醉效果和苏醒质量,减少术后并发症。

Objective:To observe and analyze the anesthetic effect of ultrasound-guided lumbar plexus+sacral plexus nerve block combined with laryngeal mask general anesthesia on elderly patients undergoing total hip arthroplasty(THA).Methods:A total of 90 elderly patients with elective unilateral THA were divided into observation group and control group according to different anesthesia methods,with 45 cases in each group.The control group was given general anesthesia with laryngeal mask,while the observation group carried out ultrasound-guided lumbar plexus+sacral plexus block combined with general anesthesia with laryngeal mask.Changes of hemodynamic indicators,anesthesia-related indicators,anesthetic effect,recovery quality and occurrence of postoperative complications were compared between the two groups.Results:The HR and MAP at T1 and T6 in the observation group were lower than those in the control group(P<0.05).The total dosage of anesthetic drugs,alertness/sedation score and total incidence rate of postoperative complications were lower in the observation group than those in the control group,while the excellent anesthesia effect rate was higher than that in the control group,the postoperative recovery time and laryngeal mask removal time were shorter than those in control group,and the differences between the two groups were statistically significant(P<0.05).Conclusion:Ultrasound-guided lumbar plexus+sacral plexus block combined with laryngeal mask general anesthesia can effectively maintain hemodynamic stability in elderly patients with THA,and help enhance the anesthetic effect and recovery quality,and reduce the postoperative complications.