超声引导下腰丛-坐骨神经阻滞与腰硬联合麻醉在单侧全髋关节置换术中的效果比较

Comparison of ultrasound-guided lumbar plexus-sciatic nerve block and combined spinal-epidural anesthesia in unilateral total hip replacement arthroplasty

目的:对比超声引导下腰丛-坐骨神经阻滞与腰硬联合麻醉在单侧全髋关节置换术中的应用效果。方法:将我院65例行单侧全髋关节置换术的患者随机分为两组,其中A组(n=32)采用腰硬联合麻醉,B组(n=33)采用超声引导下腰丛-坐骨神经阻滞麻醉。比较两组患者生命体征变化情况、麻醉效果及不良反应。结果:A组患者麻醉后5min、10min、30min的HR、MAP均较麻醉前明显降低(P<0.05),但B组患者麻醉后5min、10min、30min的HR、MAP、Sp O2与麻醉前比较差异无统计学意义(P>0.05);A组麻醉起效时间(1.19±0.23)min,显著短于B组的(5.19±0.97)min(P<0.05);A组麻醉优良率100%,B组为90.91%,组间差异不明显(P>0.05);不良反应两组对比无差异。结论:超声引导下腰丛-坐骨神经阻滞与腰硬联合麻醉在单侧全髋关节置换术中均具有较好的麻醉效果,但腰硬联合麻醉能够显著缩短麻醉起效时间,而超声引导下腰丛-坐骨神经阻滞则对患者循环系统影响较小。

Objective To compare the effect of ultrasound-guided LSNB and CSEA in unilateral hip replacement.Methods 65 patients undergoing unilateral total hip replacement arthroplasty in our hospital were randomly divided into two groups.Group A(n=32) was treated with CSEA,while group B(n=33) was treated with LSNB by ultrasound-guided.The changes of vital signs and the effect of anesthesia were compared between the two groups,Results The HR and MAP of5 min,10 min and 30 min in the group A were lower than before anesthesia(P<0.05).But there was no significant difference in group B(P>0.05).The onset time of anaesthesia in group A was(1.19±0.23)min,shorter than group B(5.19±0.97)min(P<0.05).The excellent rate of anesthesia in group A was 100.0%,group B was 90.91%,and there was no significant difference between the groups(P>0.05).There was no difference between the two groups of adverse reactions.Conclusion Ultrasound-guided LSNB and CSEA in unilateral total hip replacement arthroplasty has good anesthesia effect,but the CSEA can significantly shorten the onset time of anesthesia,while ultrasound-guided LSNB effect on the circulatory system were relatively small