超声引导下神经阻滞联合全麻对下肢骨折患者血流动力学及苏醒后躁动的影响
The effect of ultrasound-guided nerve block combined with general anesthesia on hemodynamics and postoperative restlessness in patients with lower limb fractures
郭静 1潘富鹏1
作者信息
- 1. 新乡市第一人民医院麻醉科,新乡 453000
- 折叠
摘要
目的 探讨超声引导下神经阻滞联合全麻对下肢骨折患者血流动力学及苏醒后躁动的影响.方法 选择2022年3月至2023年6月在本院择期行手术治疗的76例下肢骨折患者,按随机数字表法将入组的76例患者分为联合组与对照组,每组38例.对照组行全麻,联合组行超声引导下神经阻滞联合全麻.对比2组围术期相关指标、血流动力学指标、苏醒期躁动及不良反应发生情况.结果 联合组苏醒时间为(10.4±2.4)min、拔管时间为(14±3)min,短于对照组的(13.2±3.0)min、(18±4)min,术后6 h疼痛程度为(1.22±0.26)分、丙泊酚使用量为(186±25)mg、瑞芬太尼使用量为(0.74±0.16)mg,低于对照组的(3.16±0.32)分、(329±50)mg、(0.92±0.22)mg(P＜0.05);2组T0时平均动脉压(MAP)、心率(HR)比较,差异无统计学意义(P＞0.05),2组T1时MAP、HR均低于T0时,且联合组T2～T4时MAP、HR均低于对照组(P＜0.05);联合组T2～T4时MAP、HR与T0时比较,差异无统计学意义(P＞0.05);联合组苏醒期躁动及不良反应总发生率均低于对照组(P＜0.05).结论 下肢骨折中行超声引导下神经阻滞联合全麻可使麻醉药物使用量减少,维持血流动力学稳定,减轻患者疼痛程度,减少苏醒期躁动及不良反应发生,促进患者早期苏醒与拔管.
Abstract
Objective To explore the effects of ultrasound-guided nerve block combined with general anesthesia on hemodynamics and postoperative restlessness in patients with lower limb fractures.Methods Seventy-six patients with lower limb fractures who underwent elective surgical treatment in our hospital from March 2022 to June 2023 were selected.The enrolled patients were randomly divided into a combination group(n=38)and a reference group(n=38)using a random number table method.The reference group received general anesthesia,while the combination group received ultrasound-guided nerve block combined with general anesthesia.Perioperative related indicators,hemodynamic indicators,agitation during recovery,and incidence of adverse reactions were compared between two groups.Results The recovery time and the extubation time were(10.4±2.4)min and(14±3)min,which was shorter than the reference group's(13.2±3.0)min and(18±4)min,respectively.The postoperative pain level was(1.22±0.26)min,the dosage of propofol was(186±25)mg,and the dosage of remifentanil was(0.74±0.16)mg,which was lower than the reference group's(3.16±0.32)min,(329±50)mg,and(0.92±0.22)mg respectively(P＜0.05).There were no statistically significant difference in mean arterial pressure(MAP)and heart rate(HR)between the two groups at T0(P＞0.05).Both groups had lower MAP and HR at T1 than at T0,and the combined group had lower MAP and HR at T2-T4 than the reference group(P＜0.05);There were no statistically significant difference(P＞0.05)in MAP and HR between the T2-T4 combination group and TO group.The total incidence of restlessness and adverse reactions during the recovery period in the combination group was lower than that in the reference group(P＜0.05).Conclusion Ultrasound guided nerve block combined with general anesthesia in lower limb fractures can reduce the use of anesthetic drugs,maintain hemodynamic stability,alleviate patient pain,reduce agitation and adverse reactions during recovery,and promote early recovery and extubation.
关键词
下肢/骨折/麻醉,全身/神经传导阻滞/超声检查/血流动力学/苏醒谵妄Key words
Lower extremity/Fractures/Anesthesia,general/Nerve block/Ultrasounography/Hemodynamics/Emergence delirium引用本文复制引用
出版年
2024
NETL
NSTL
万方数据