腰丛-坐骨神经阻滞麻醉与腰硬联合麻醉用于高龄股骨粗隆间骨折患者手术的效果比较

目的比较分析高龄股骨粗隆间骨折患者手术中采用腰丛-坐骨神经阻滞麻醉与腰硬联合麻醉的效果。方法选取2016年4月至2018年7月行手术治疗的高龄股骨粗隆间骨折患者86例,根据麻醉方案分为A组和B组,每组43例。A组采用腰丛-坐骨神经阻滞麻醉,B组采用腰硬联合麻醉,比较两组运动阻滞时间、感觉阻滞时间、术后恢复效果及麻醉不良反应情况。结果 A组运动阻滞和感觉阻滞的起效时间及持续时间均长于B组,差异有统计学意义(P<0.05);A组肛门排气时间及住院时间均短于B组,术后3个月Harris评分高于B组,差异有统计学意义(P<0.05);A组麻醉不良反应发生率明显低于B组,差异有统计学意义(P<0.05)。结论腰丛-坐骨神经阻滞麻醉可有效延长高龄股骨粗隆间骨折患者麻醉阻滞时间,减少麻醉不良反应发生,提高术后恢复效果。

Comparison of lumbar plexus-sciatic nerve block anesthesia and combined spinal-epidural anesthesia in elderly patients undergoing intertrochanteric fracture surgery

Objective To compare the effects of lumbar plexus and sciatic nerve block anesthesia and waist hard joint anesthesia in surgical treatment of intertrochanteric fracture in aged patients.Methods From April 2016 to July 2018,86 elderly patients with intertrochanteric fracture of femur underwent surgical treatment in our hospital were selected.According to the random number table method,they were divided into group A and group B,with 43 cases in each group.Group A was anesthetized with lumbar plexus-sciatic nerve block.Group B received combined spinal-epidural anesthesia.The motor block time,sensory block time,postoperative recovery effect and adverse reactions of anesthesia were compared between the two groups.Results The motor block and sensory blockade effect time and duration were longer than those in group B,the differences were significant(P<0.05).the anal exhaust time and hospital stay were shorter in group B,Harris score was higher at 3 months after operation than those of group B,the differences were significant(P<0.05).The incidence of adverse reactions of anesthesia in group A was lower than that in group B,the difference was significant(P<0.05).Conclusions Lumbar plexus and sciatic nerve block anesthesia can effectively extend the intertrochanteric fracture in aged patients anesthesia blocks of time,reduce the anesthetic adverse reactions,and improve the effect of postoperative recovery.