超声联合神经刺激仪定位髂筋膜联合腰骶丛神经阻滞与椎管内麻醉对高龄骨科手术患者的影响

Effect of Ultrasound Combined With Neurostimulator on Iliac Fascia Combined With Lumbosacral Plexus Nerve Block and Intraspinal Anesthesia in Elderly Orthopedic Surgery Patients

目的探讨超声联合神经刺激仪定位髂筋膜联合腰骶丛神经阻滞与椎管内麻醉对高龄骨科手术患者的影响。方法选取2021年11月至2023年1月我院收治的高龄骨科手术治疗患者60例为研究对象,遵循随机对照原则分为观察组和对照组,各组30例。对照组采用椎管内麻醉方式,观察组采用超声联合神经刺激仪定位髂筋膜联合腰骶丛神经阻滞。统计两组应激反应、MMSE评分、VAS评分。结果T0,两组应激反应指标比较,P>0.05,T1~T4,观察组患者应激反应指标水平均低于对照组患者,P<0.05;术前,两组患者MMSE评分比较,P>0.05,术后第1d、第3d、第7d,观察组MMSE评分均高于对照组患者,P<0.05;术后6h、12h、24h,观察组VAS评分均低于对照组VAS评分,P<0.05。结论超声联合神经刺激仪定位髂筋膜联合腰骶丛神经阻滞在高龄骨科手术中应用效果显著,能够降低术后应激反应和疼痛,提高患者认知能力,是一种值得推广的麻醉方式。

Objective To investigate the effect of iliac fascia localization combined with lumbosacral plexus block and intra spinal anesthesia on elderly patients undergoing orthopedic surgery.Methods A total of 60 elderly orthopedic surgery patients treated in our hospital from November 2021 to January 2023 were selected as the study objects,and were divided into observation group and control group according to the principle of randomized control,with 30 cases in each group.The control group was given intraspinal anesthesia,and the observation group was given iliac fascia location combined with lumbosacral plexus block by ultrasound combined with nerve stimulator.The stress response,MMSE score and VAS score of the two groups were analyzed.Results T0,the stress response indexes of the two groups were compared,P>0.05,T1~T4,the stress response indexes of the observation group were lower than those of the control group,P<0.05;before surgery,the MMSE score of the two groups was compared,P>0.05;on the 1st,3rd and 7th day after surgery,the MMSE score of the observation group was higher than that of the control group,P<0.05;the VAS scores of the observation group were lower than those of the control group at 6h,12h and 24h after operation(P<0.05).Conclusion Localization of iliac fascia combined with lumbosacral plexus nerve block by ultrasound combined with neurostimulator is effective in elderly orthopedic surgery,which can reduce postoperative stress response and pain and improve patients'cognitive ability.It is a kind of anesthesia method worth promoting.