目的:探究腹股沟韧带上髂筋膜间隙与骶丛神经阻滞在老年股骨粗隆间骨折手术中的应用价值。方法:选取2022年8月—2023年8月于黄石工矿医院进行股骨粗隆间骨折手术治疗的66例老年患者作为研究对象,采用随机数表法将患者分为常规阻滞组(腰...目的:探究腹股沟韧带上髂筋膜间隙与骶丛神经阻滞在老年股骨粗隆间骨折手术中的应用价值。方法:选取2022年8月—2023年8月于黄石工矿医院进行股骨粗隆间骨折手术治疗的66例老年患者作为研究对象,采用随机数表法将患者分为常规阻滞组(腰交感神经阻滞)和联合阻滞组(腹股沟韧带上髂筋膜间隙联合骶丛神经阻滞),各33例。比较两组术中相关指标、麻醉满意度、疼痛程度及不良反应。结果:联合阻滞组感觉和运动阻滞起效时间和完全时间长于常规阻滞组,麻醉满意度高于常规阻滞组,差异有统计学意义(P<0.05)。联合阻滞组手术切皮即刻和手术结束即刻视觉模拟评分法(VAS)评分高于常规阻滞组,而术后24 h VAS评分低于常规阻滞组,差异有统计学意义(P<0.05);但两组手术开始后30 min VAS评分比较,差异无统计学意义(P>0.05)。联合阻滞组头痛、恶心、呕吐及尿潴留发生率低于常规阻滞组,差异有统计学意义(P<0.05);两组均未发生严重并发症。结论:老年股骨粗隆间骨折手术患者给予腹股沟韧带上髂筋膜间隙联合骶丛神经阻滞,可提升镇痛、镇静效果,提升麻醉满意度,并减少术后不良反应。展开更多
Regional anesthesia is an integral component of successful orthopedic surgery.Neuraxial anesthesia is commonly used for surgical anesthesia while peripheral nerve blocks are often used for postoperative analgesia.Pati...Regional anesthesia is an integral component of successful orthopedic surgery.Neuraxial anesthesia is commonly used for surgical anesthesia while peripheral nerve blocks are often used for postoperative analgesia.Patient evaluation for regional anesthesia should include neurological,pulmonary,cardiovascular,and hematological assessments.Neuraxial blocks include spinal,epidural,and combined spinal epidural.Upper extremity peripheral nerve blocks include interscalene,supraclavicular,infraclavicular,and axillary.Lower extremity peripheral nerve blocks include femoral nerve block,saphenous nerve block,sciatic nerve block,iPACK block,ankle block and lumbar plexus block.The choice of regional anesthesia is a unanimous decision made by the surgeon,the anesthesiologist,and the patient based on a risk-benefit assessment.The choice of the regional block depends on patient cooperation,patient positing,operative structures,operative manipulation,tourniquet use and the impact of postoperative motor blockade on initiation of physical therapy.Regional anesthesia is safe but has an inherent risk of failure and a relatively low incidence of complications such as local anesthetic systemic toxicity(LAST),nerve injury,falls,hematoma,infection and allergic reactions.Ultrasound should be used for regional anesthesia procedures to improve the efficacy and minimize complications.LAST treatment guidelines and rescue medications(intralipid)should be readily available during the regional anesthesia administration.展开更多
文摘目的:探究腹股沟韧带上髂筋膜间隙与骶丛神经阻滞在老年股骨粗隆间骨折手术中的应用价值。方法:选取2022年8月—2023年8月于黄石工矿医院进行股骨粗隆间骨折手术治疗的66例老年患者作为研究对象,采用随机数表法将患者分为常规阻滞组(腰交感神经阻滞)和联合阻滞组(腹股沟韧带上髂筋膜间隙联合骶丛神经阻滞),各33例。比较两组术中相关指标、麻醉满意度、疼痛程度及不良反应。结果:联合阻滞组感觉和运动阻滞起效时间和完全时间长于常规阻滞组,麻醉满意度高于常规阻滞组,差异有统计学意义(P<0.05)。联合阻滞组手术切皮即刻和手术结束即刻视觉模拟评分法(VAS)评分高于常规阻滞组,而术后24 h VAS评分低于常规阻滞组,差异有统计学意义(P<0.05);但两组手术开始后30 min VAS评分比较,差异无统计学意义(P>0.05)。联合阻滞组头痛、恶心、呕吐及尿潴留发生率低于常规阻滞组,差异有统计学意义(P<0.05);两组均未发生严重并发症。结论:老年股骨粗隆间骨折手术患者给予腹股沟韧带上髂筋膜间隙联合骶丛神经阻滞,可提升镇痛、镇静效果,提升麻醉满意度,并减少术后不良反应。
文摘Regional anesthesia is an integral component of successful orthopedic surgery.Neuraxial anesthesia is commonly used for surgical anesthesia while peripheral nerve blocks are often used for postoperative analgesia.Patient evaluation for regional anesthesia should include neurological,pulmonary,cardiovascular,and hematological assessments.Neuraxial blocks include spinal,epidural,and combined spinal epidural.Upper extremity peripheral nerve blocks include interscalene,supraclavicular,infraclavicular,and axillary.Lower extremity peripheral nerve blocks include femoral nerve block,saphenous nerve block,sciatic nerve block,iPACK block,ankle block and lumbar plexus block.The choice of regional anesthesia is a unanimous decision made by the surgeon,the anesthesiologist,and the patient based on a risk-benefit assessment.The choice of the regional block depends on patient cooperation,patient positing,operative structures,operative manipulation,tourniquet use and the impact of postoperative motor blockade on initiation of physical therapy.Regional anesthesia is safe but has an inherent risk of failure and a relatively low incidence of complications such as local anesthetic systemic toxicity(LAST),nerve injury,falls,hematoma,infection and allergic reactions.Ultrasound should be used for regional anesthesia procedures to improve the efficacy and minimize complications.LAST treatment guidelines and rescue medications(intralipid)should be readily available during the regional anesthesia administration.
