评价超声引导下髂筋膜神经阻滞联合腰麻在老年髋关节置换术中的应用效果分析

Analysis of application effect of ultrasound-guided iliac fascia nerve block combined with spinal anesthesia in hip arthroplasty in the elderly

目的 分析老年髋关节置换术中应用超声引导下髂筋膜神经阻滞联合腰麻的效果。方法 50例髋关节置换术老年患者,依据不同麻醉方式分为对照组和观察组,每组25例。对照组应用常规腰麻,观察组应用超声引导下髂筋膜神经阻滞联合腰麻。对比两组患者麻醉起效及成功时间、术后并发症发生率。结果 观察组感觉及运动麻醉起效时间和成功时间分别为(2.13±1.20)、(3.44±1.92)min和(8.15±2.32)、(13.15±2.82)min,均短于对照组的(3.02±1.10)、(4.35±0.82)min和(9.44±2.05)、(14.98±3.50)min,差异有统计学意义(P<0.05)。观察组术后并发症发生率12.00%低于对照组的48.00%,差异有统计学意义(P<0.05)。结论 在老年髋关节置换术中选用超声引导下髂筋膜神经阻滞联合腰麻可有效缩短麻醉起效及成功时间,且安全性高,值得在临床中积极推广应用。

Objective To analyze the effect of ultrasound-guided iliac fascia nerve block combined with spinal anesthesia in hip arthroplasty in the elderly.Methods A total of 50 elderly patients with hip arthroplasty were divided into the control group and the observation group according to different anesthesia methods,with 25 cases in each group.The control group received conventional spinal anesthesia,and the observation group received ultrasound-guided iliac fascia nerve block combined with spinal anesthesia.The time of onset and success of anesthesia and the incidence of postoperative complications were compared between the two groups.Results The time of onset and success of sensory and motor anesthesia in the observation group were(2.13±1.20),(3.44±1.92)min and(8.15±2.32),(13.15±2.82)min,which were shorter than those of(3.02±1.10),(4.35±0.82)min and(9.44±2.05),(14.98±3.50)min in the control group,and the differences were statistically significant(P<0.05).The incidence of postoperative complications in the observation group was 12.00%,which was lower than that of 48.00%in the control group,and the difference was statistically significant(P<0.05).Conclusion The combination of ultrasound-guided iliac fascia nerve block and spinal anesthesia in hip arthroplasty in the elderly can effectively shorten the time of onset and success of anesthesia,and has high safety,which is worthy of active promotion and application in clinical practice.