超声引导下髂筋膜间隙多点阻滞复合喉罩在老年患者股骨粗隆间手术中的麻醉效果观察

【摘要】 目的 探讨超声引导下髂筋膜间隙多点阻滞复合喉罩全麻在老年患者股骨粗隆间骨折的麻醉效果。方法〓选择老年患者70例,年龄65~89岁,ASAⅡ~Ⅲ级,根据已接受的麻醉分为S组(髂筋膜间隙阻滞组)与Y组(腰硬联合阻滞组),每组各35例。记录各组患者在麻醉前、髂筋膜/腰硬联合麻醉操作时、注药后10 min、20 min及置入喉罩时血压、心率,两组患者术中血管活性药物使用率,术中液体入量,术后48小时镇痛效果及不良反应。结果〓S组在髂筋膜穿刺操作时血压、心率明显低于腰硬联合操作时(P<0.05)|注药后10 min、20 min及喉罩置入后血压S组高于Y组,心率低于Y组(P<0.05),S组术中液体入量少于Y组(P<0.05)|Y组的血管活性药物使用率高于S组(P<0.05),Y组不良反应发生高于S组(P<0.05)|术后48小时镇痛VAS评分比较,两组无显著差异。结论〓超声引导下髂筋膜间隙多点阻滞复合喉罩全麻在老年患者股骨粗隆手术麻醉中效果确切,患者生命征更平稳,镇痛效果满意,且不良反应发生率低。

Effect of ultrasound-guided multi point block in the fascia iliac gap combined with laryngeal mask anesthesia in elderly patients with intertrochanteric surgery

【Abstract】〓Objective〓To explore the effect of ultrasound-guided multi point block in the fascia iliac gap combined with laryngeal mask anesthesia in elderly patients underwent intertrochanteric femoral surgery. Methods〓Seventy cases of elderly patients aged 65-89 years old and ASA Ⅱ~Ⅲ grade, were selected. The patients are divided into two groups, iliac fascia gap anesthesia (S group, 35 cases) and iliac fascia gap combined spinal-epidural anesthesia (Y group, 35 cases). The blood pressure and heart rate are recorded in the following five points of time, before anesthesia, anaesthetizing, after the injection of 10 min, after the injection of 20 min and laryngeal mask airway being imbedded. The use rate of vasoactive drug, the volume of liquid used during the operation, the analgesic effect of 48 hours after surgery and the adverse reaction were also recorded. Results〓The blood pressure and heart rate of S group were significantly lower than those of Y group when anaesthetizing (P<0.05). The blood pressure of S group was higher than that of Y group but the heart rate was lower than Y group when and after the injection of 10 min, 20 min, after laryngeal mask airway was imbedded (P<0.05). The volume of liquid used during the operation in S group was less than that of Y group (P<0.05). The use rate of vasoactive drug and the adverse reaction of Y group were higher than those of S group (P<0.05). There were no differences between these two groups in VAS score 48 hours after surgery. Conclusion〓The approach of ultrasound-guided multi point block in iliac fascia gap combined with laryngeal mask anesthesia had good outcomes in treating elderly patients with intertrochanteric fracture.