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静脉泵注右美托咪定联合超声引导下腰骶丛神经阻滞在髋部骨折手术中的镇静效果及认知安全性评价
作者:王西建  孙干 
单位:山东国欣颐养集团新汶中心医院 麻醉科, 山东 泰安 271219
关键词:静脉泵注右美托咪定 超声引导 腰骶丛神经阻滞 髋部骨折 镇静效果 认知安全性 
分类号:R681.6
出版年·卷·期(页码):2021·49·第二期(144-147)
摘要:

目的:分析静脉泵注右美托咪定复合超声引导下腰骶丛神经阻滞在髋部骨折手术中的镇静效果及认知安全性情况。方法:选取本院接受髋部骨折手术的患者103例作为受试对象,借助随机数字表将受试对象随机分为观察组(50例)和对照组(53例);其中对照组实施超声引导下腰骶丛神经阻滞,观察组在对照组的基础上静脉泵注右美托咪定。对比两组患者不同时间点的镇静效果、麻醉结局指标,并观察其认知安全性是否受到影响。结果:两组患者不同时间点的VAS评分比较,差异具有统计学意义(P<0.05),且观察组不同时间点的VAS评分均低于对照组,差异均具有统计学意义(P<0.05)。观察组切皮时(T1)、关节置换时(T2)、术毕(T3)的平均动脉压(MAP)及心率(HR)均低于对照组,差异均具有统计学意义(P<0.05)。两组患者手术前后的数字广度、数字符号、循迹连线、词语流畅性、简易智力状况检查法(MMSE)评分及并发症的发生率比较,差异均无统计学意义(P>0.05)。结论:静脉泵注右美托咪定联合超声引导下腰骶丛神经阻滞在髋部骨折手术中的镇静效果优于超声引导下腰骶丛神经阻滞,且不影响患者术后的认知功能及并发症发生率,值得临床推广使用。

Objective:To analyze the sedative effect and cognitive safety of dexmedetomidine combined with ultrasound-guided lumbosacral plexus block in hip fracture surgery.Methods: In this study, 103 patients with hip fracture surgery in our hospital were randomly divided into observation group (50 cases) and control group (53 cases) by random number table; the control group was given ultrasound-guided lumbosacral plexus block, and the observation group was given dexmedetomidine by intravenous pump on top of ultrasound-guided lumbosacral plexus block.The sedation effect and anesthesia outcome indexes of the two groups at different time points were compared, and whether the cognitive safety was affected was observed. Results: The visual analogue scale(VAS) scores of the two groups at different time points were significantly different (P<0.05), and the VAS scores of the observation group were lower than those of the control group at different time points, and the differences were statistically significant (P<0.05). Mean arterial pressure(MAP) and heart rate(HR) levels of T1, T2 and T3 in the observation group were lower than those in the control group, and the differences were statistically significant (P<0.05). There was no significant difference in the number span, number symbol, trace line, word fluency score, mini-mental state examination(MMSE) score and complication rate between the two groups before and after operation (P>0.05). Conclusion: The sedative effect of dexmedetomidine combined with ultrasound-guided lumbosacral plexus block in hip fracture surgery is better than that of ultrasound-guided lumbosacral plexus block, moreover it does not affect the postoperative cognitive function and the incidence of complications, which is worthy of clinical application.

参考文献:

[1] CLAβEN T,SCHEID C,LANDGRAEBER S,et al.Characteristics of elective hip replacement in the elderly[J].Der Orthopde,2017,46(1):1-9.
[2] 桂江华,邓建平,罗和国,等.B超引导下腰丛-坐骨神经阻滞应用于老年髋关节置换术麻醉效果研究[J].当代医学,2019,25(18):96-98.
[3] 罗方毅,喻旭娇,樊雅玲,等.超声引导下前路腰丛联合臀上皮神经阻滞在老年人髋关节置换手术中的临床应用[J].国际麻醉学与复苏杂志,2019,40(7):636-639.
[4] 马力.右美托咪定辅助全身麻醉对患者血流动力学指标的影响及术后镇痛效果[J].河南外科学杂志,2020,26(1):63-64.
[5] 许啸波,余功敏,叶兴宏,廖武军.右美托咪定对老年全麻手术患者苏醒期应激状况及血流动力学的影响[J].浙江创伤外科,2019,24(6):1298-1299.
[6] 陈恒利,彭康祖,要亚仙,等.麻醉因素对老年患者髋部骨折术后转归的影响:meta分析[J].中华麻醉学杂志,2019,39(12):1425-1429.
[7] 赖尚导,陈伟元,谌业光,等.3种麻醉方式在老年髋部骨折手术治疗中的应用效果[J].临床骨科杂志,2019,22(6):708-711.
[8] 胡强,汤守营,郑立生.老年髋部骨折患者围术期并发症影响因素分析[J].临床合理用药杂志,2018,11(2):167-168.
[9] 金鑫,郑晓铸,夏燕飞.超声引导下肢神经阻滞复合右美托咪定持续泵注在老年重危患者髋关节置换术中的应用[J].广东医学,2017,38(7):1094-1097.
[10] 安爱荣.右美托咪定在老年髋部骨折手术中对术后镇痛效果及谵妄的影响分析[J].中国伤残医学,2020,28(8):85-87.
[11] 段伟琴,张生茂,白香花,等.右美托咪定对老年髋部骨折患者术后急性应激障碍的影响[J].中国实用医药,2019,14(15):112-113.
[12] 王素芬,朱忠.超声引导下腰骶丛神经阻滞复合静脉泵注右美托咪定在髋关节置换术患者中的临床应用[J].浙江创伤外科,2018,23(3):604-605.

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