超声引导下肢神经阻滞复合右美托咪定持续泵注在老年髋关节置换术中镇痛效果与对应激水平呼吸循环的影响
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摘要
目的:探讨超声引导下肢神经阻滞复合右美托咪定持续泵注对老年髋关节置换术患者镇痛效果、应激水平及呼吸循环功能的影响。方法:选择2016年1月至2017年8月期间在医院进行单侧髋关节置换术的128例患者作为研究对象,按照随机数字表法将128例患者分为观察组和对照组,每组各64例。观察组采用超声引导下腰丛+坐骨神经阻滞复合右美托咪定(DEX)持续泵注,对照组采用全身麻醉复合DEX静脉泵注,术后两组均持续静脉镇痛48h。比较两组患者镇痛效果、应激水平、呼吸循环功能。结果:所有患者均成功完成手术,两组患者手术基本情况无明显差异(P>0.05);观察组患者术后2、4、8、12、24和48hVAS评分均明显低于对照组(P<0.05); TO时刻两组Cor水平比较无差异(P>0.05),两组其余各个时刻Cor水平均有明显降低,其中观察组明显低于对照组(P <0.05);两组患者T0时刻MAP、HR、RR比较无差异(P>0.05),两组MAP、HR、RR均有不同程度的下降,其中观察组MAP与RR水平明显高于对照组(P <0.05),HR与对照组比较无明显差异(P>0.05);两组不同时间段SpO2比较无差异(P>0.05)。结论:超声引导下肢神经阻滞复合右美托咪定持续泵注在老年髋关节手术中应用效果良好,能够保持呼吸循环功能的稳定,应激反应小,术后镇痛效果好,有效减少术后不良反应的发生。
Objective: To explore the effect of continuous ultrasound guided lower limb nerve block combined with dexmedetomidine continuous infusion on pain relief,stress level and respiratory and circulatory function in elderly patients undergoing hip replacement. Methods: A total of 128 patients undergoing unilateral hip arthroplasty from January 2016 to August 2017 were selected as the subjects. According to the random number table method,128 patients were divided into the observation group and the control group,64 cases in each group. The observation group was treated with ultrasound guided lumbar plexus and sciatic nerve block combined with dexmedetomidine(DEX) continuous infusion. The control group received general anesthesia combined with DEX intravenous infusion. After operation,the two groups continued intravenous analgesia 48 h.The analgesic effect,stress level and respiratory and circulatory function were compared between the two groups. Results: All the patients completed the operation successfully. There was no significant difference in the basic operation between the two groups(P >0.05). The scores of 2,4,8,12,24 and 48 hVAS in the observation group were significantly lower than those in the control group(P <0.05). At the time of TO,there was no difference in Cor level between the two groups(P > 0. 05),and the Cor level of the two groups decreased at all other times,which was significantly lower in the observation group than in the control group(P<0.05). Two groups of MAP,HR and RR decreased to varying degrees. The levels of MAP and RR in the observation group were significantly higher than those in the control group(P < 0. 05). HR had no significant difference compared with the control group(P >0.05),and there was no difference in SpO2 between the two groups at different time periods(P >0.05). Conclusion: Ultrasound-guided lower extremity nerve block combined with dexmedetomidine continuous pump has good effect in elderly hip surgery,which can maintain the stability of respiratory and circulatory function,less stress response,good analgesic effect after operation,and effectively reduce the occurrence of adverse reactions after operation.
Objective: To explore the effect of continuous ultrasound guided lower limb nerve block combined with dexmedetomidine continuous infusion on pain relief,stress level and respiratory and circulatory function in elderly patients undergoing hip replacement. Methods: A total of 128 patients undergoing unilateral hip arthroplasty from January 2016 to August 2017 were selected as the subjects. According to the random number table method,128 patients were divided into the observation group and the control group,64 cases in each group. The observation group was treated with ultrasound guided lumbar plexus and sciatic nerve block combined with dexmedetomidine(DEX) continuous infusion. The control group received general anesthesia combined with DEX intravenous infusion. After operation,the two groups continued intravenous analgesia 48 h.The analgesic effect,stress level and respiratory and circulatory function were compared between the two groups. Results: All the patients completed the operation successfully. There was no significant difference in the basic operation between the two groups(P >0.05). The scores of 2,4,8,12,24 and 48 hVAS in the observation group were significantly lower than those in the control group(P <0.05). At the time of TO,there was no difference in Cor level between the two groups(P > 0. 05),and the Cor level of the two groups decreased at all other times,which was significantly lower in the observation group than in the control group(P<0.05). Two groups of MAP,HR and RR decreased to varying degrees. The levels of MAP and RR in the observation group were significantly higher than those in the control group(P < 0. 05). HR had no significant difference compared with the control group(P >0.05),and there was no difference in SpO2 between the two groups at different time periods(P >0.05). Conclusion: Ultrasound-guided lower extremity nerve block combined with dexmedetomidine continuous pump has good effect in elderly hip surgery,which can maintain the stability of respiratory and circulatory function,less stress response,good analgesic effect after operation,and effectively reduce the occurrence of adverse reactions after operation.
引文
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