不同麻醉方式对下肢骨科手术患者术后镇痛效果以及排尿方式的影响

Effects of Different Anesthesia Methods on Postoperative Analgesia and Urination Style in Patients Undergoing Lower Limb Department of Orthopedics Operation

目的对照比较全身麻醉与外周神经阻滞麻醉对骨科手术患者术后镇痛及排尿方式的影响,为临床骨科手术患者麻醉方式选择提供科学依据。方法回顾性分析2015年6月—2017年6月在该院行骨科手术治疗下肢骨折的112例患者基本临床资料,结合该次研究课题设计对照实验,采用数字随机分组法将下肢骨折患者均分成采用全身麻醉方式的对照组与神经外周阻滞麻醉方式的观察组。以疼痛视觉模拟量表(VAS)作为术后镇痛效果评估依据,分别统计两组术后6、12、24、48 h4个时间点所对应的VAS评分并行组间比较,计算两组患者自行排尿率。结果与对照组比较,观察组术后6、12、24、48 h VAS评分明显要低,组间差异有统计学意义(t=4.106,t=5.071,t=7.215,t=9.283,P<0.05)。观察组术后自行排尿得的患者有39例(69.6%)明显多于对照组41.1%(23/56)(x^2=7.058,P<0.05)。结论兼具减轻患者术后疼痛与尽早恢复患者正常排尿应用优势的外周神经阻滞麻醉对下肢骨科手术患者十分适用,值得临床优先考虑使用。

Objective To compare the effects of general anesthesia and peripheral nerve block anesthesia on postoperative analgesia and urination in patients undergoing orthopedic surgery, and to provide scientific basis for the selection of anesthesia methods in clinical orthopedic surgery. Methods The clinical data of 112 patients with fracture of lower limb from June 2015 to June 2017 in our hospital were retrospectively analyzed. combined with the design of this study, the patients with lower limb fracture were divided into two groups: control group and observation group. Using the pain visual analogue scale(vas) as the basis for postoperative analgesia, the vas scores of the two groups were statistically compared between the two groups at 6 hours, 12 hours, 24 hours and 48 hours respectively. Results Compared with the control group, the vas scores in the observation group were significantly lower at 6,12,24,48 h after operation. there were significant differences between the two groups(t=4.106, t=5.071, t=7.215,t=9.283, P<0.05). In the observation group, 39 cases(69.6%) were significantly more than the control group(41.1%)(23/56)(x^2=7.058,P<0.05). Conclusion The peripheral nerve block anesthesia with the advantage of reducing postoperative pain and early recovery of normal urination in patients with lower limb orthopedic surgery is very suitable for patients with lower limb orthopedic surgery,and it is worth considering the clinical application.