超声引导下腰丛-坐骨神经阻滞复合右美托咪定持续泵注在老年髋关节置换术中的应用效果分析

目的 探讨超声引导下腰丛-坐骨神经阻滞复合右美托咪定持续泵注在老年髋关节置换术中的应用效果.方法 回顾性分析2017年1月至2019年3月南阳市骨科医院收治的分别采用超声引导下腰丛-坐骨神经阻滞复合右美托咪定持续泵注麻醉行髋关节置换术的51例老年患者(设为研究组)与右美托咪定持续泵注复合全身麻醉行髋关节置换术的51例老...

Analysis of the Effect of Ultrasound guided Lumbar Plexus sciatic Nerve Block Combined with Continuous Pumping of Dexmedetomidine on Elderly Patients Undergoing Hip Replacement

Objective To explore the effect of ultrasound-guided lumbar plexus-sciatic nerve block combined with continuous pumping of dexmedetomidine on elderly patients undergoing hip replacement surgery.Methods Medical records of 51 elderly patients,who were admitted to Nanyang Orthopaedic Hospital from January 2017 to March 2019 and given ultrasound-guided lumbar plexus-sciatic nerve block combined with continuous pump of dexmedetomidine for hip replacement surgery(set as the study group)and medical records of 51 elderly patients who were admitted to the same hospital and given continuous pumping of dexmedetomidine combined with general anesthesia for hip replacement surgery(set as control group)were retrospectively analyzed.The anaesthesia time,surgery time,blood transfusion volume,usage amount of dexmedetomidine,and heart rate(HR),average arterial pressure(MAP)and blood oxygen saturation(SpO2)at time points after entering operation room(T0),immediately after anaesthesia induction(T1),5 min after anaesthesia induction(T2),30 min after anaesthesia induction(T3),and after surgery(T4)in the two groups were compared.Visual analogue scale(VAS)was used to assess the pain degree of patients at 2,4,8,12,24,48 h after surgery.Results(1)No significant difference was observed in anesthesia time,surgery time and blood transfusion volume between the two groups(all P>0.05)and usage amount of dexmedetomidine in the study group was significantly lower than that in the control group(t=9.612,P=0.000).(2)At T1,T2,T3 and T4,no significant change was observed in HR and MAP in the study group(all P>0.05),the HR and MAP in the control group showed a trend of decrease first followed by increase(F=12.560,4.643,P=0.000,0.001).The HR and MAP in the study group were significantly higher than those in the control group at T1,T2 and T3(HR:t=2.130,2.089,2.091,P=0.036,0.039,0.039;MAP:t=2.043,2.676,2.323,P=0.044,0.009,0.022),and HR and MAP in the study group were significantly lower than those in the control group at T4(t=2.609,1.993,P=0.011,0.049);no significant change was observed in the level of SpO2 within the two groups at T1,T2,T3 and T4(all P>0.05)and the comparison between the two groups(all P>0.05)showed no statistically significant difference.(3)At 2,4,8,12,24 and 48 h after the surgery,the VAS scores in the two groups showed a trend of decrease first followed by increase,and then decrease(F=85.860,32.650,all P=0.000)and the VAS scores in the study group were significantly lower than those in the control group at 2,4,8,and 12 h after the surgery(t=14.380,12.540,11.490,15.960,all P=0.000);no significant difference was observed in the VAS scores between the two groups at 24 and 48 h after the surgery(all P>0.05).Conclusion Ultrasound-guided lumbar plexus-sciatic nerve block combined with continuous pumping of dexmedetomidine can help to reduce the usage amount of anesthetic drugs for elderly patients undergoing hip replacement surgery,keep their haemodynamics stable and alleviate their pain,so it has good clinical effect.