摘要
目的:分析全麻联合B超下髂筋膜阻滞(FICB)在髋部手术老年患者中的可行性。方法:将2020年6月-2022年5月福建医科大学附属闽东医院骨科110例老年手术患者根据不同麻醉方法纳入全麻组、联合组,全麻组55例应用全麻,联合组55例应用全麻联合FICB,对比两组疼痛程度[视觉模拟评分法(VAS)]、应激反应[皮质醇(Cor)、心钠素(ANP)、肾上腺素(E)、去甲肾上腺素(NE)]、认知功能[简易智力状态检查量表(MMSE)]、谵妄及不良反应(恶心呕吐、寒战、呼吸抑制、头晕)的发生率。结果:联合组术后各时间点VAS评分均低于全麻组(P<0.05);联合组术后1 d的Cor、ANP、E、NE均低于全麻组(P<0.05);联合组术后1 d的MMSE评分高于全麻组(P<0.05);联合组谵妄及不良反应发生率分别为5.45%、7.27%,低于全麻组的18.18%、21.82%(P<0.05)。结论:全麻联合FICB的麻醉效果好,可减轻骨科老年手术患者的疼痛程度与应激反应,且对患者认知功能的影响小,谵妄及不良反应发生率低,可推行。
Objective:To analyze the feasibility of general anesthesia combined with fascia iliac compartment block (FICB) under B-ultrasound in elderly patients undergoing orthopaedic surgery.Method:From June 2020 to May 2022,110 elderly patients in the Department of Orthopedics in Mindong Hospital Affiliated to Fujian Medical University were included in the general anesthesia group and the combined group according to different anesthesia methods,55 patients in the general anesthesia group were given general anesthesia and 55 patients in the combined group were given general anesthesia combined with FICB.The pain degree[visual analog scale (VAS)],stress response[cortisol (Cor),atrial natriuretic peptide (ANP),epinephrine (E),norepinephrine (NE)],cognitive function[mini-mental state examination (MMSE)],delirium and the incidence of adverse reactions (nausea,vomiting,chills,respiratory depression,dizziness) were compared between two groups.Result:The VAS score of the combined group at each times after surgery were lower than those of the general anesthesia group (P<0.05).The levels of Cor,ANP,E and NE in the combined group at 1 d after surgery were lower than those in the general anesthesia group (P<0.05).The MMSE score of the combined group at 1 d after surgery was higher than that of the general anesthesia group (P<0.05).The incidence of delirium and adverse reactions in the combined group were 5.45% and 7.27%,which were lower than 18.18% and 21.82% in the general anesthesia group (P<0.05).Conclusion:General anesthesia combined with FICB has a good anesthetic effect,can reduce the pain degree and stress reaction of elderly orthopaedic patients,and has little impact on the cognitive function of patients,the incidence of delirium and adverse reactions are low,which can be promoted.
作者
缪星亮
翁迪贵
黄庆清
蒋润年
MIAO Xingliang;WENG Digui;HUANG Qingqing;JIANG Runnian(Mindong Hospital Affiliated to Fujian Medical University,Fu’an 355000,China;不详)
出处
《中外医学研究》
2022年第32期26-29,共4页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
全麻
B超下髂筋膜阻滞
骨科
老年手术患者
General anesthesia
Fascia iliac compartment block under B-ultrasound
Orthopaedics
Elderly surgical patients
