喉罩全身麻醉联合超声引导下神经阻滞在骨科老年患者髋部手术中的应用效果

目的探讨喉罩全身麻醉联合超声引导下神经阻滞在骨科老年患者髋部手术中的应用效果。方法回顾性分析2016年8月至2018年12月本院86例老年髋部手术患者的临床资料,根据术中麻醉方式将其分为A组(喉罩全身麻醉+超声引导下神经阻滞)与B组(气管插管静吸全身麻醉)、C组(腰硬联合麻醉)。比较三组的HR、MAP、麻醉时间、苏醒时间、术后认知功能障碍及谵妄发生情况。结果 A组T1、T2、T3、T4、T5时的HR、MAP均低于B、C组(P<0.05);A组的苏醒时间短于B、C组(P<0.05);A组的术后认知功能障碍及谵妄发生率均低于B、C组,差异具有统计学意义(P<0.05);B、C组上述指标比较,差异均无统计学意义(P>0.05)。A、B、C三组的麻醉时间比较,差异均无统计学意义(P>0.05)。结论骨科老年患者髋部手术中联用喉罩全身麻醉与超声引导下神经阻滞的麻醉效果理想。

Application effect of laryngeal mask general anesthesia combined with ultrasoundguided nerve block in hip surgery of elderly patients in orthopaedic department

Objective To investigate the application effect of laryngeal mask general anesthesia combined with ultrasound-guided nerve block in hip surgery of elderly patients in orthopaedic department.Methods The clinical data of86 elderly patients who underwent hip surgery in our hospital from August 2016 to December 2018 were analyzed retrospectively.According to the intraoperative anesthesia methods,the patients were divided into group A(laryngeal mask general anesthesia and ultrasound-guided nerve block),group B(endotracheal intubation and aspiration general anesthesia)and group C(lumbar epidural combined anesthesia).The HR,MAP,anesthesia time,wake time,the occurrences ofpostoperative cognitive dysfunction and delirium in the three groups were compared.Results The HR and MAP of the group A at T1,T2,T3,T4 and T5 were lower than those of group B and C(P<0.05);the waking time of the group A were shorter than that of the group B and C(P<0.05);the incidences of postoperative cognitive dysfunction and delirium of the group A were lower than those of the group B and C,the differences were statistically significant(P<0.05);there were no significant differences in the above indexes between the group B and C(P>0.05).There were no significant differences in the anaesthesia time among the group A,B and C(P>0.05).Conclusion The anaesthesia effect of laryngeal mask general anesthesia combined with ultrasound-guided nerve block in hip surgery of elderly patientsin orthopaedic department is ideal.