超声引导下腰丛复合坐骨神经阻滞麻醉在老年股骨粗隆间骨折患者麻醉中的有效性及安全性

Efficacy and Safety of Ultrasound-guided Low Back Plexus Combined Sciatic Nerve Block Anesthesia in Elderly Patients with Intertrochanteric Fracture of Femur

目的:分析超声引导下腰丛复合坐骨神经阻滞麻醉在老年股骨粗隆间骨折患者麻醉中的有效性及安全性。方法:选取2020年10月—2023年10月枣庄市台儿庄区人民医院进行治疗的老年股骨粗隆间骨折患者520例作为研究对象,采用随机数字表法分为对照组和观察组,每组260例。两组均采用人工股骨头置换术,对照组采用蛛网膜下腔阻滞麻醉复合硬膜外麻醉,观察组采用超声引导下腰丛复合坐骨神经阻滞麻醉。比较两组感觉神经、运动神经阻滞麻醉起效时间以及麻醉维持时间、并发症发生率。结果:观察组感觉神经、运动神经阻滞麻醉起效时间短于对照组,麻醉维持时间长于对照组,差异有统计学意义(P<0.001)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.001)。观察组麻醉优良率高于对照组,差异有统计学意义(P<0.001)。结论:超声引导下腰丛复合坐骨神经阻滞麻醉在老年股骨粗隆间骨折患者麻醉中的效果较好,麻醉起效时间快,维持时间长,并发症发生风险较低。

Objective:To analyze the efficacy and safety of ultrasound-guided lower back plexus combined with sciatic nerve block anesthesia in elderly patients with intertrochanteric fracture of femur.Methods:Five hundred and twenty elderly patients with intertrochanteric fracture of femur treated in Zaozhuang Taierzhuang District People's Hospital from October 2020 to October 2023 were selected as the study objects,and were divided into control group and observation group by random number table method,with two hundred and sixty cases in each group.Both groups underwent artificial femoral head replacement,the control group under⁃went subarachnoid block anesthesia combined with epidural anesthesia,and the observation group underwent ultrasound-guided low back plexus combined with sciatic nerve block anesthesia.The onset time,maintenance time and complication rate of sensory nerve and motor nerve block anesthesia were compared between the two groups.Results:The onset time of sensory nerve and motor nerve block anesthesia in the observation group was shorter than that in the control group,and the duration of anesthesia was longer than that in the control group,the difference was statistically significant(P<0.001).The complication rate of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.001).The excellent and good rate of anesthesia in the observation group was higher than that in the control group,the difference was statistically significant(P<0.001).Conclusion:Ultrasound-guided lower back plexus combined sciatic nerve block anesthesia in elderly patients with intertrochanteric fracture of femur is effective,effective time is fast,maintenance time is long,and the risk of complications is low.