摘要
目的:探讨连续髂筋膜腔阻滞复合喉罩全麻在老年患者股骨上段手术中的可行性及安全性。方法:择期86例行股骨上段手术的老年患者,随机分成两组:A组(连续髂筋膜腔阻滞复合喉罩全麻组),B组(连续硬膜外阻滞复合喉罩全麻组)。记录麻醉前(T0)、髂筋膜腔或硬膜外腔穿刺置管完成5分钟时(T1)、注入局麻药20分钟时(T2)、全麻诱导置入喉罩时(T3)患者的MAP、HR;术中每小时液体入量、麻黄碱的用量;术后48小时内的镇痛效果及术后并发症。结果:A、B两组MAP、HR在T0时比较无差异(P>0.05),在T1、T2、T3时比较有显著差异(P<0.05);两组术中每小时液体入量及麻黄碱的用量比较有显著差异(P<0.05);术后48小时镇痛效果无差异,而恶心、呕吐、尿潴留等并发症B组高于A组。结论:连续髂筋膜腔阻滞复合喉罩全麻可安全用于老年患者股骨上段手术且能避免硬膜外腔穿刺时因反复摆放体位引起患者疼痛而诱发的应激反应,能更好的维持术中血流动力学的稳定,且术后恶心、呕吐及尿潴留的发生率低。
Objective ：To investigate the feasibility and security of continuous Fascia iliea compartment block and general anesthesia with laryngeal mask airway used in upper thigh - bone of elderly patient operation. Methods ： 86 cases of elderly patients on upper thigh - bone of optional operation are divided randomly into two groups- Group A （continuous Fascia ilica compartment block and general anesthesia with laryngeal mask airway group） and Group B （continuous epidural block and general anesthesia with laryngeal mask airway group）. Record patients＇MAP and HR respectively after five minutes of Anesthesia（ T0）, Fascia ilica compartment/epidural compartment tubing by puncturing（ Tl ） , twenty minutes after pouring in local anesthesia medicine（ T2 ） , and when general anesthesia lead to imbed laryngeal mask airway（ T3 ）, liquid inputs, Ephedrine dosage during an operation per hour;analgesic effect in 48 hours and complication after postoperation, ,ResultS：In Group A and B, the MAP, HR had no statistically significance on TO （ P 〉 0.05 ）, and had statistically significance on T1 ,T2 ,T3 （ P 〈 0.05 ） ; liquid inputs, Ephedrine dosage during an operation per hour had statistically significance （ P 〈 0.05 ） ; analgesic effect in 48 hours had no statistically significance （ P 〉 0.05 ） ; but complication such as nausea, vomit,uroschesis, Group B is higher than that of Group A. Conclusion： Continuous Fascia iliea compartment block and general anesthesia with laryngeal mask airway used in upper thigh - bone of elderly patient operation is safe, and can avoid the pain which cause to happen stressing, caused by putting position repeatedly,when punctured in epidural space, can keep the haemodynamics＇ steady better in surgery,and can lower the incidence rate of nausea,vomit,urosehesis after surgery.
出处
《医学信息（中旬刊）》
2011年第2期429-430,共2页
Medical Information Operations Sciences Fascicule
关键词
连续髂筋膜腔阻滞
喉罩
全身麻醉
老年
股骨骨折
Continuous Fascia ilica compartment block
Laryngeal mask airway
General anesthesia
Old patientL
Thighbone fracture
