超声引导下腰骶丛神经阻滞联合全身麻醉对 髋关节置换术安全性的影响

Effect of Ultrasound-guided Lumbosacral Sacral Plexus Block Combined with General Anesthesia on the Safety of Hip Joint Replacement

摘要:

〔摘 要〕 目的：探讨超声引导下腰骶丛神经阻滞联合全身麻醉在髋关节置换术患者中的应用效果。 方法：选取郑 州大学附属郑州中心医院 2019 年 3 月至 2021 年 4 月收治的 108 例髋关节置换术患者，按照随机数字表法分为对照组 和观察组，各 54 例。对照组给予全身麻醉，观察组实施全身麻醉联合超声引导下腰骶丛神经阻滞，比较两组患者血 流动力学指标、谵妄发生率、麻醉效果及并发症发生情况。 结果：观察组患者麻醉后 15 min（T1）、麻醉后 30 min（T2） 及出手术室前（T3）时舒张压（DBP）、收缩压（SBP）、心率（HR）均低于对照组患者，差异具有统计学意义 （P ＜ 0.05）；观察组患者术后谵妄总发生率低于对照组患者，差异具有统计学意义（P ＜ 0.05）；观察组患者运动 阻滞持续时间、麻醉起效时间、术后拔管时间均短于对照组患者，差异具有统计学意义（P ＜ 0.05）；两组患者并发 症发生情况比较，差异无统计学意义（P ＞ 0.05）。 结论：超声引导下腰骶丛神经阻滞与全身麻醉联合对髋关节置换 术患者的麻醉效果较好，安全性高。

Abstract:

〔Abstract〕 Objective To investigate the effect of ultrasound-guided lumbosacral sacral plexus block combined with general anesthesia in patients with hip replacement. Methods A total of 108 patients with hip replacement admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from March 2019 to April 2021 were selected and divided into a control group and an observation group according to random number table method, with 54 cases in each group. The control group was given general anesthesia, and the observation group was given general anesthesia combined with ultrasound-guided lumbosacral sacral plexus block. Hemodynamic indexes, cognitive function scores, anesthesia effects and complications were compared between the two groups. Results 15 min after anesthesia (T1), 30 min after anesthesia (T2) and before leaving the operating room (T3), the diastolic blood pressure (DBP), systolic blood pressure (SBP) and heart rate (HR) in the observation group were lower than those in the control group, and the differences were statistically significant (P < 0.05). The total incidence of postoperative delirium in the observation group was lower than that in the control group, and the difference was statistically significant (P < 0.05). The duration of motor block, onset time of anesthesia and postoperative extubation time in observation group were shorter than those in control group, and the differences were statistically significant (P < 0.05). There was no significant difference in the occurrence of complications between the two groups (P > 0.05). Conclusion Ultrasound-guided lumbosacral sacral plexus block combined with general anesthesia is effective and safe for patients with hip replacement.