B超指导下腰丛神经阻滞联合喉罩浅全麻对老年全髋关节置换术患者的影响

Effect of Lumbar Plexus Block Combined with Laryngeal Mask Airway Shallow General Anesthesia under the Guidance of Ultrasound in Elderly Patients Undergoing Total Hip Replacement

目的:探究B超指导下腰丛神经阻滞(LPB)联合喉罩浅全麻(GA)对老年全髋关节置换术(THA)患者血流动力学、麻醉质量的影响.方法:选取2021年1月至2023年1月于本院行THA治疗的82例老年患者为研究对象.按麻醉方案,将其分为研究组(n=41,予以B超指导下的LPB联合喉罩浅GA)和对照组(n=41,予以气管插管GA).比较两组患者麻醉效果、麻醉前、麻醉30min、术毕时刻血流动力学[心脏指数(CI)、平均动脉压(MAP)]水平变化.结果:两组患者麻醉优良率比较,差异无统计学意义(P>0.05);两组患者麻醉30min、术毕时刻CI、MAP水平均较麻醉前升高,但研究组患者较对照组低,差异均有统计学意义(P<0.05).结论:老年THA患者行B超指导下LPB联合喉罩浅GA与气管插管GA麻醉效果相当,但前者更有助于维持机体血流动力学稳定.

Objective:To explore the effect of lumbar plexus block(LPB)combined with laryngeal mask airway shallow general anesthesia(GA)under the guidance of ultrasound on hemodynamics and anesthesia quality in elderly patients undergoing total hip replacement(THA).Methods:A total of 82 elderly patients with THA in our hospital from January 2021 to January 2023 were collected as the study subjects.They were divided into observation group(n=41,using LPB combined with laryngeal mask airway shallow GA under the guidance of B ultrasound)and control group(n=41,using conventional GA with trachea cannula)according to different anesthesia schemes.The effects of anesthesia were compared between the two groups,and the levels of changes in hemodynamics[cardiac index(CI),and mean arterial pressure(MAP)]before anesthesia,30 minutes of anesthesia,and time after surgery.Results:There was no significant difference in the excellent and good rate of anesthesia between the two groups(P>0.05).The levels of CI,and MAP in observation group were lower than those in control group at 30 minutes of anesthesia and at the end of operation,and the differences were statistically significant(P<0.05).Conclusion:The effect of LPB combined with laryngeal mask airway shallow GA under the guidance of ultrasound in elderly THA patients is equivalent,comparing with the conventional GA anesthesia.But the former is more helpful to maintain the stability of hemodynamics.