腰椎旁神经阻滞联合全凭静脉全身麻醉对髋关节置换术患者血流动力学、应激反应、术后苏醒的影响

目的 观察腰椎旁神经阻滞联合全凭静脉全身麻醉对髋关节置换术患者血流动力学、应激反应、术后苏醒的影响.方法 选取2018年1月—2019年8月我院收治的行髋关节置换术患者115例,根据手术麻醉方法 的不同分为观察组60例和对照组55例,观察组予腰椎旁神经阻滞联合全凭静脉全身麻醉,对照组仅予全凭静脉全身麻醉.比较两组麻醉...

Effects of Lumbar Paraspinal Nerve Block Combined with Total Intravenous General Anesthesia on Hemodynamics,Stress Response and Postoperative Recovery in Patients Undergoing Hip Replacement

Objective To observe the effect of lumbar paraspinal nerve block combined with total intravenous general anesthesia on hemodynamics,stress response and postoerative recovery after hip replacement.Methods From January 2018 to August 2019,115 patients undergoing hip replacement were selected and divided into observation group(n=60)and control group(n=55)according to different anesthesia methods.The observation group was treated with lumbar paraspinal nerve block combined with total intravenous general anesthesia,while the control group was only treated with total intravenous general anesthesia.The changes of mean arterial pressure(MAP),heart rate(HR),norepinephrine and epinephrine levels before anesthesia(T0),at 10 min after anesthesia(T1),30 min after anesthesia(T2),and at the end of operation(T3)were compared between the two groups.The recovery time and the effect of conscious sedation after operation,as well as the occurrence of adverse reactions during operation in the two groups were also compared.Results MAP and HR of the observation group at T1,T2 and T3 were slightly higher than those at T0,but the difference was not statistically significant(P>0.05).MAP and HR of the control group at T1,T2 and T3 were all higher than those at T0,and MAP and HR of the observation group at T2 were the highest and then declined to the levels of T1 at T3(P<0.05).MAP and HR at T1,T2 and T3 in the observation group were lower than those in the control group(P<0.05).At T1,T2 and T3,norepinephrine and epinephrine in the two groups were higher than those at T0,and the level of norepinephrine and epinephrine in the observation group was lower than that in the control group at the same time point(P<0.05 or P<0.01).The postoperative alertness/sedation score of the observation group was lower than that of the control group,and the recovery time was significantly shorter than that of the control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Lumbar paraspinal nerve block combined with total intravenous general anesthesia can effectively prevent the fluctuation of hemodynamic indexes,reduce the degree of stress response,help patients wake up quickly after operation,with good quality of wake-up but without increasing the occurrence of adverse reactions during operation.