目的:探讨老年下肢骨科手术患者通过应用腰丛-坐骨神经阻滞基础疗法联合右美托咪定的麻醉效果.方法:选取2020年7月—2022年6月天津市天津医院收治的拟行手术治疗的104例老年下肢骨科手术患者作为研究对象,按照随机数表法将患者分为常规组(腰丛-坐骨神经阻滞麻醉)和实验组(腰丛-坐骨神经阻滞+右美托咪定),每组各52例.对比两组患者的起效时间及维持时间,术中丙泊酚及舒芬太尼使用量,术前与术后12 h、24 h视觉疼痛模拟(VAS)和术后不良反应.结果:实验组的感觉神经阻滞起效时间短于常规组、持续时间长于常规组,差异有统计学意义(t= 13.251、12.741,P＜0.05);实验组丙泊酚及舒芬太尼使用量均低于常规组,差异有统计学意义(t=32.847、12.854,P＜0.05);与本组术前、与术后12h相比,两组患者术后24 h VAS评分均降低,且实验组VAS评分均低于常规组,差异有统计学意义(t=6.080、8.302,P＜0.05).两组患者不良反应发生率,差异无统计学意义(χ2=0.122,P＞0.05).结论:老年下肢骨科手术患者通过应用腰丛-坐骨神经阻滞基础疗法联合右美托咪定,有利于进一步提高患者的麻醉效果,减少患者的丙泊酚和舒芬太尼使用剂量,可进一步改善患者的麻醉镇静效果,患者的疼痛感较小,安全有效.
Anesthesia Effect of Lumbar Plexus-sciatic Nerve Block Combined with Dexmedetomidine for Orthopedic Surgery of the Lower Extremities in the Elderly People
Objective:To investigate the effect of anesthesia in elderly patients undergoing orthopedic surgery of the lower extremities by applying basic lumbar plexus-sciatic nerve block combined with dexmedetomidine.Methods:104 cases of elderly lower limb orthopedic surgery patients admitted to the hospital for proposed surgical treatment from July 2020 to June 2022 were selected as the study subjects,and the patients were divided into the conventional group(lumbar plexus-sciatic nerve block anesthesia)and the experimental group(lumbar plexus-sciatic nerve block + dexmedetomidine)according to the method of randomized number table,with 52 cases in each group.The onset and maintenance times,intraoperative propofol and sufentanil use,preoperative versus postoperative 12 h and 24 h visual pain simulation(VAS)and postoperative adverse events were compared between the two groups.Results:The onset of sensory nerve block in the experimental group was shorter and longer than that in the conventional group,and the difference was statistically significant(t=13.251,12.741;P＜0.05).The amount of propofol and sufentanil used in the experimental group was lower than that in the conventional group,and the difference was statistically significant(t=32.847,12.854;P＜0.05).Compared with the preoperative and with the 12 h postoperative period in this group,the 24 h postoperative VAS scores of patients in both groups were reduced,and the VAS scores of the experimental group were lower than those of the conventional group,and the difference was statistically significant(t=6.080,8.302;P＜0.05).The difference in the incidence of adverse reactions between the two groups was not statistically significant(χ2=0.122,P＞0.05).Conclusion:By applying lumbar plexus-sciatic nerve block basic therapy combined with dexmedetomidine in elderly lower limb orthopedic surgery patients,it is conducive to further improve the anesthetic effect of patients,reduce the dosage of propofol and sufentanil used in patients,which can further improve the effect of anesthesia and sedation of patients,and the patients have less pain,which is safe and effective.
万方数据
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