超声引导下神经阻滞复合全身麻醉在胫骨骨折手术中的应用

发布时间：2018-02-04 00:35

本文关键词： 超声神经阻滞全身麻醉胫骨骨折可行性安全性　出处：《江西医药》2016年04期 　论文类型：期刊论文

【摘要】：目的探究超声引导下神经阻滞复合全身麻醉在胫骨骨折手术中的应用效果及安全性评价。方法选择2012年4月至2015年4月收治的择期行胫骨骨折切开复位内固定手术的患者共61例,按照入院时间顺序随机分为对照组与观察组,对照组患者接受全身麻醉,观察组患者接受超声引导下神经阻滞复合全身麻醉。比较两组患者丙泊酚使用量、苏醒时间、拔管相关情况及并发症发生率。结果观察组丙泊酚使用量明显少于对照组,t=10.4611,P0.05。观察组苏醒时间及拔管时间短于对照组,t=7.9737,10.5306,P0.05。两组患者麻醉前Ramsay评分及VAS评分无明显差异,P0.05。观察组拔管后10min Ramsay评分低于对照组,t=10.0741,P0.05。观察组拔管后30min VAS评分明显低于对照组,t=5.4134,P0.05。两组患者并发症发生率无统计学差异,P0.05。结论超声引导下神经阻滞复合全身麻醉能减少丙泊酚用量,缩短苏醒时间及拔管时间,能够有效镇静、镇痛,安全无明显不良反应,值得临床推广应用。
[Abstract]:Objective to evaluate the efficacy and safety of ultrasound guided nerve block combined with general anesthesia in the operation of tibial fracture. Methods selective tibial fracture incision was performed from April 2012 to April 2015. There were 61 cases of reduction and internal fixation. According to the time of admission, the patients in the control group were randomly divided into control group and observation group. The patients in the control group received general anesthesia, and the patients in the observation group received ultrasound guided nerve block combined with general anesthesia. The usage of propofol was compared between the two groups. Results the usage of propofol in the observation group was significantly lower than that in the control group (10.4611). P0.05.The time of recovery and extubation in the observation group was shorter than that in the control group (7.9737 / 10.5306). There was no significant difference in Ramsay score and VAS score between the two groups before anesthesia. The Ramsay score in the observation group was lower than that in the control group 10 minutes after extubation. The VAS score in the observation group was significantly lower than that in the control group at 30 minutes after extubation. P0.05.There was no significant difference in the incidence of complications between the two groups. Conclusion Ultrasound-guided nerve block combined with general anesthesia can reduce the dosage of propofol, shorten the recovery time and extubation time. Can be effective sedation, analgesia, safety and no obvious adverse reactions, worthy of clinical application.
【作者单位】：江西省宜丰县人民医院麻醉科;
【分类号】：R614.2
【正文快照】： 胫骨骨折作为骨科常见的急症之一,有较高的发病率,多合并腓骨骨折,发病率约占四肢骨折的3.77%[1]。临床上治疗胫骨骨折多采用切开复位内固定治疗[2],随着社会-心理-医学模式不断发展,麻醉理念也得到不断发展,从最初的顺利完成手术发展为增加麻醉舒适度、提高麻醉的安全性。近

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