超声引导下腰骶丛神经阻滞联合全麻应用于高龄患者髋部骨折手术中的效果

Effect of Ultrasound-guided Lumbosacral Plexus Block Combined with General Anesthesia in Elderly Patients with Hip Fractures

目的探讨高龄髋部骨折患者全麻同时联合超声辅助腰骶丛神经阻滞的效果。方法选取2021年7月—2023年7月高邮市中医医院收治的90例高龄髋部骨折患者为研究对象,以随机数表法分为对照组(全麻)和观察组(全麻联合超声引导下腰骶丛神经阻滞),各45例。比较两组患者手术前后生命体征、术后疼痛情况和不良反应发生情况。结果术中观察组平均动脉压(98.65±7.41)mmHg、心率(75.32±5.49)次/min均高于对照组,差异有统计学意义(t=5.765、3.276,P均<0.05)。术后3、6、12、24 h观察组疼痛评分均低于对照组,差异有统计学意义(P均<0.05)。两组不良反应总发生率对比,差异无统计学意义(χ^(2)=1.131,P>0.05)。结论高龄患者髋部骨折手术采用超声引导腰骶丛神经阻滞联合全麻,患者术中生命体征稳定,可减轻术后疼痛,麻醉安全性高。

Objective To investigate the effect of comprehensive and simultaneous ultrasound-guided lumbosacral plexus block on elderly patients with hip fractures.Methods A total of 90 elderly patients with hip fracture admitted to Gaoyou Hospital of Traditional Chinese Medicine from July 2021 to July 2023 were selected as the study objects,and they were divided into control group(general anesthesia)and observation group(ultrasound-guided lumbosacral plexus block)by random number table method with 45 cases in each group.The vital signs before and after operation,postoperative pain and incidence of adverse reactions were compared between the two groups.Results The mean arterial pressure(98.65±7.41)mmHg and heart rate(75.32±5.49)times/min in the observation group were higher than those in the control group,and the differences were statistically significant(both P<0.05).The pain scores of the observation groups at 3,6,and 12 and 24 hours after operation were lower than those in the control group,and the differences were statistically significant(all P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(χ^(2)=1.131,P>0.05).Conclusion The use of ultrasound-guided lumbosacral plexus block combined with general anesthesia in the operation of elderly patients with hip fractures can stabilize the patients'vital signs during the operation,reduce postoperative pain,and have high anesthesia safety.