摘要
Abstract
Objective:To investigate the effect of ultrasound-guided lumbar plexus sciatic nerve block(LP-SNB)combined with general anesthesia in elderly patients undergoing total hip arthroplasty(THA).Methods:A total of 100 elderly THA patients admitted to Shandong First Rehabilitation Hospital from February 2022 to February 2023 were selected as the study objects,and were divided into a control group and a study group according to random number table method,with 50 cases in each group.The control group received general anesthesia,and the study group combined with ultrasound-guided LP-SNB on the basis of the control group.The hemodynamic indicators,analgesic effect,stress response,postoperative recovery situation and the occurrence of adverse reactions were compared between the two groups.Results:At the time of incision and 30 minutes during the operation,the heart rates and mean arterial pressures of the study group were lower than those of the control group,the differences were statistically significant(P<0.05).At 6 h,12 h and 24 h after surgery,the Pain Visual Analogue Scale scores of the study group were(3.41±0.35)points,(2.87±0.33)points and(2.04±0.29)points,respectively,which were lower than(4.18±0.43)points,(3.81±0.39)points and(2.89±0.33)points of the control group,the differences were statistically significant(P<0.05).Tuenty-four hours after surgery,the levels of cortisol,norepinephrine and C-reactive protein in the study group were(227.36±22.14)pg/mL,(284.86±28.54)pg/mL and(12.15±1.33)mg/L,respectively,which were lower than(249.79±23.08)pg/mL,(308.41±33.58)pg/mL and(14.46±1.52)mg/L in the control group,the differences were statistically significant(P<0.05).The time of recovery,extubation,stay in the anesthesia room and the first time getting out of bed after the operation were(15.26±1.48)min,(18.63±2.25)min,(40.14±4.36)min,(1.89±0.25)d,respectively,which were shorter than(18.47±1.54)min,(20.49±2.32)min,(50.71±5.98)min and(2.46±0.33)d in the control group,the differences were statistically significant(P<0.05).The incidence of adverse reactions in the study group was 10.00%,which was not statistically significant compared with 12.00%in the control group(P>0.05).Conclusion:Ultrasound-guided LP-SNB combined with general anesthesia can enhance the analgesic effect inperioperative analgesia of elderly patients undergoing THA,maintain the stability of intraoperative hemodynamics,and is safe and reliable.关键词
髋关节置换术/超声引导腰丛-坐骨神经阻滞/全身麻醉/镇痛效果Key words
Total hip arthroplasty/Ultrasound-guided lumbar plexus sciatic nerve block/General anesthesia/Analgesic effect分类
临床医学
