髂筋膜阻滞复合腰硬联合麻醉 在老年髋部骨折患者中的应用效果评价

Evaluation of Application Effect of Fascia Iliaca Block Plus Combined Spinal-Epidural Anesthesia in Elderly Patients with Hip Fracture

目的:探究髂筋膜阻滞复合腰硬联合麻醉在老年髋部骨折患者中的应用效果。方法:将盱眙县中医院麻醉科收治的老年髋部骨折患者80例(收治时间2021年2月—2023年2月)作为研究对象,随机分为两组,每组40例。两组均实施手术治疗,对照组实施腰硬联合麻醉,观察组实施髂筋膜阻滞复合腰硬联合麻醉。比较两组麻醉效果。结果:术前,两组简易精神状态评价量表(MMSE)评分对比,差异无统计学意义(P>0.05);术后6 h、1 d、3 d,两组MMSE评分升高,且观察组均高于对照组(P<0.05)。观察组手术时间短于对照组,舒芬太尼用量少于对照组(P<0.05)。术前,两组视觉模拟评分法(VAS)评分对比,差异无统计学意义(P>0.05);术后6 h、1 d、3 d,两组VAS评分降低,且观察组均低于对照组(P<0.05)。两组麻醉效果相比,差异无统计学意义(P>0.05)。结论:老年髋部骨折患者实施腰硬联合麻醉复合髂筋膜阻滞,能够改善患者术后认知功能,减轻疼痛,缩短手术时间,减少舒芬太尼用量。

Objective:To explore the application effect of fascia iliaca block plus combined spinal-epidural anesthesia in elderly patients with hip fracture.Methods:A total of 80 elderly patients with hip fracture admitted to Anesthesiology Department of Xuyi County Traditional Chinese Medicine Hospital(admission time:from February 2021 to February 2023)were selected as the study subjects.They were randomly divided into two groups with 40 cases in each group.Both groups underwent surgical treatment,the control group received combined spinal-epidural anesthesia,and the observation group received fascia iliaca block plus combined spinal-epidural anesthesia.The anesthesia effects of the two groups were compared.Results:Before surgery,there was no significant difference in the scores of Mini-Mental State Examination scale(MMSE)between the two groups(P>0.05).At 6 h,on 1 d,and on 3 d after surgery,the MMSE scores in the two groups increased,and the scores in the observation group were higher than those in the control group(P<0.05).The operation time in the observation group was shorter than that in the control group,and the dosage of sufentanil in the observation group was less than that in the control group(P<0.05).Before surgery,there was no significant difference in the scores of Visual Analogue Scale(VAS)between the two groups(P>0.05).At 6 h,on 1 d,and on 3 d after surgery,the VAS scores in the two groups decreased,and the scores in the observation group were lower than those in the control group(P<0.05).There was no significant difference in anesthesia effect between the two groups(P>0.05).Conclusion:Fascia iliaca block plus combined spinal-epidural anesthesia in elderly patients with hip fracture can improve the postoperative cognitive function of patients,relieve pain,shorten the operation time,and reduce the dosage of sufentanil.