摘要
目的:探讨针刺麻醉复合丙泊酚和瑞芬太尼靶控输注喉罩静脉麻醉在股骨颈骨折手术治疗中的应用价值。方法:选取2017年6月至2019年6月在湖北六七二中西医结合骨科医院行股骨颈骨折手术的102例患者作为研究对象。根据麻醉方式不同将其分为观察组(53例)和对照组(49例),对照组采取复合丙泊酚和瑞芬太尼靶控输注喉罩静脉麻醉,观察组在对照组基础上增加针刺麻醉,同时给予两组快速康复护理干预。比较两组术中指标和麻醉效果、术后麻醉不良反应发生情况及术后不同时相点疼痛评分。结果:术中观察组使用瑞芬太尼和丙泊酚用量、心率、平均脉动圧均低于对照组(均P<0.05);观察组麻醉优良率98.11%,高于对照组的87.76%(P<0.05);观察组术后麻醉总不良率5.66%,低于对照组的18.37%(P<0.05);术后1 d、1周时,两组患者疼痛评分比较,差异无统计学意义(P>0.05)。结论:股骨颈骨折手术中,采取针刺麻醉复合丙泊酚和瑞芬太尼靶控输注喉罩静脉麻醉,不仅有利于减少麻醉药物用量,降低术中应激反应,还有利于降低术后麻醉不良反应发生率,缓解术后疼痛,促进早日康复,值得推广应用。
Objective:To determine the value of acupuncture anesthesia plus intravenous anesthesia with target⁃controlled infusion of propofol/remifentanil and laryngeal mask airway in patients with femoral neck fractures.Methods:Included in this study were 102 patients who underwent femoral neck fracture surgery in No.672 Orthopedics Hospital of Integrated Traditional Chinese and Western Medicine Hubei between June 2017 and June 2019.According to anesthesia methods,they were divided into the study group(n=53)and control group(n=49).The control group was given intravenous anesthesia via target⁃controlled infusion of propofol/remifentanil and with laryngeal mask airway.The study group was given acupuncture anesthesia on the basis of anesthesia in the control group.T both groups also received nursing care for rapid rehabilitation.The intraoperative indexes and anesthesia outcomes,incidence of postoperative anesthesia⁃related adverse reactions,and pain scores at different time points after surgery were compared between the two groups.Results:The dosage of remifentanil/propofol,heart rate and mean pulse pressure in the study group were lower than those in the control group(all P<0.05).The rate of excellent and good anesthesia outcome in the study group was 98.11%,which was higher than that(87.76%)in the control group(P<0.05).The overall rate of postoperative anesthesia⁃related adverse reactions in the study group was 5.66%,which was lower than that(18.37%)in the control group(P<0.05).There was no statistically significant difference in pain scores between the two groups at 1 day and 1 week after surgery(P>0.05).Conclusion:At surgery for femoral neck fracture,acupuncture anesthesia plus intravenous anesthesia via target controlled infusion of propofol/remifentanil and with laryngeal mask is conducive not only to reducing anesthetics dosage,stress at surgery,postoperative anesthesia⁃related adverse reactions and postoperative pain,but also to earlier recovery,and therefore is worthy of widespread use in clinical setting.
作者
胡敏岚
Hu Minlan(Department of Anesthesiology,No.672 Orthopedics Hospital of Integrated Traditional Chinese and Western Medicine,Wuhan 430070,Hubei,China)
出处
《广州医科大学学报》
2021年第2期94-97,共4页
Academic Journal of Guangzhou Medical University
关键词
股骨颈骨折
针刺麻醉
靶控输注
喉罩静脉麻醉
Femoral neck fracture
Acupuncture anesthesia
Target⁃controlled infusion
Intravenous anesthesia with laryngeal mask
