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-现代医学

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

单位：山东国欣颐养集团新汶中心医院麻醉科, 山东泰安 271219

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.

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