超声引导下髂筋膜神经阻滞对老年股骨近端骨折患者血流动力学与应激反应的影响

目的 分析超声引导下髂筋膜神经阻滞在老年股骨近端骨折手术麻醉中的应用,及其对患者血流动力学与应激反应的影响.方法 选取平湖市第一人民医院骨科2019年3月-2020年12月老年股骨近端骨折手术患者82例,按照随机数表法分成A组与B组,各41例,A组行全麻,B组行超声引导下髂筋膜神经阻滞联合全麻,对比2组的血流动力学指标...

Effect of ultrasound-guided iliac fascia nerve block on hemodynamics and stress response in elderly patients with proximal femoral fracture

  Objective  To analyze the application of ultrasound-guided iliac fascia nerve block in the anesthesia of elderly patients with proximal femoral fracture and its effect on hemodynamics and stress response.   Methods   Eighty-two cases of elderly patients with proximal femoral fracture in our hospital from March 2019 to December 2020 were selected and randomly divided into group A and group B, 41 cases in each group. Group A was given general anesthesia, and group B was given ultrasound-guided iliac fascia nerve block combined with general anesthesia. The hemodynamic indexes, stress reaction, anesthetic effect and adverse reactions of the two groups were compared.   Results   The arterial pressure of group B after laryngeal mask insertion [(94.70±3.83) mm Hg], 5 min after operation [(96.64±4.05) mm Hg] and at the end of operation [(98.10±3.16) mm Hg] were higher than those of the group A, and the heart rate (88.98±5.54) times/min, (84.17±3.86) times/min, (79.76±4.02) times/min were lower than that of group A (P < 0.05). The postoperative serum cortisol, atrial natriuretic peptide, plasma epinephrine and norepinephrine of group B (11.85±1.72) μg/dL, (0.28 ± 0.02) nmol/L, (37.13±5.95) ng/L, (154.71±45.87) ng/L were lower than those of group A (P < 0.05). The dosage of propofol, recovery time and extubation time of group B (413.03±66.19) mg, (9.86±1.62) min, (12.58±2.79) min were less than those of group A (P < 0.05). The incidence of adverse reactions of group B (7.32%) was lower than that of group A (24.39%), P < 0.05.   Conclusion   Iliac fascia nerve block under ultrasound has little effect on hemodynamics and stress reaction in elderly patients with proximal femoral fracture, and has good anesthetic effect and less adverse reactions, which is worthy of application.