超声引导下股神经阻滞复合全身麻醉对大隐静脉高位结扎加点式剥脱术患者术后镇痛的影响

发布时间：2018-09-12 11:03

【摘要】：目的观察超声引导下股神经阻滞复合全身麻醉对大隐静脉高位结扎加点式剥脱术患者术后镇痛的影响。方法选取2015年1月至2016年6月于该院择期行大隐静脉高位结扎点式剥脱术的70例患者作为研究对象,按随机数字表法分为对照组与观察组各35例,对照组采用喉罩全身麻醉,观察组则应用超声引导下股神经阻滞复合喉罩全身麻醉,观察麻醉前(T0)、置入喉罩即刻(T1)、手术切皮时(T2)、缝合切口时(T3)、术毕(T4)平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_2)的变化;采用视觉模拟评分(VAS)评定两组术后1、6、12、24、48h疼痛程度的变化;统计两组手术时间、局部麻醉药物用量、首次下床活动时间、术中输液量;观察术后并发症发生率。结果 (1)T0点,两组HR、MAP、SpO_2对比差异无统计学意义(P0.05);与T0点比较,观察组HR、MAP降低,SpO_2略有上升,对照组HR、MAP上升,SpO_2轻幅上升(P0.05);观察组T1~T4点HR、MAP低于对照组(P0.05),两组不同时间点SpO_2比较差异无统计学意义(P0.05);(2)与术后1h比较,术后6、12、24、48h,两组VAS略有升高,观察组术后不同时间VAS均低于对照组,差异有统计学意义(P0.05);(3)观察组局部麻醉药物用量、输液量均低于对照组,其首次下床活动时间短于对照组,差异有统计学意义(P0.05);(4)两组术后并发症发生率比较,差异无统计学意义(P0.05)。结论采用超声引导下股神经阻滞复合全身麻醉可提高大隐静脉高位结扎加点式剥脱术患者术中血流动力学的稳定性,且镇痛效果肯定。
[Abstract]:Objective to observe the effect of ultrasound-guided femoral nerve block combined with general anesthesia on postoperative analgesia in patients with high ligation and point stripping of great saphenous vein. Methods from January 2015 to June 2016, 70 patients with high ligation and point exfoliation of great saphenous vein were selected and divided into control group (n = 35) and observation group (n = 35). In the observation group, ultrasound guided femoral nerve block combined with laryngeal mask general anesthesia was used to observe the changes of (MAP), heart rate (HR), (HR), oxygen saturation (SpO_2) before anesthesia (T 0), immediately after placement of larynx mask (T 1), at incision (T 2), at suture incision (T 3) and at the end of operation (T 4). Visual analogue score (VAS) was used to evaluate the pain degree of the two groups for 48 hours after operation, the time of operation, the dosage of local anesthetic, the first time of getting out of bed, the amount of intraoperative infusion, and the incidence of postoperative complications were observed. Results (1) there was no significant difference in HR,MAP,SpO_2 between the two groups (P0.05), and HR,MAP decreased slightly in the observation group compared with the T0 point. In the control group, the HR,MAP increased slightly (P0.05), the HR,MAP at the T1~T4 point in the observation group was lower than that in the control group (P0.05), and there was no significant difference in SpO_2 between the two groups at different time points (P0.05); (2). The VAS of the observation group was lower than that of the control group at different time after operation, the difference was statistically significant (P0.05); (3) the dosage of local anesthetic and the amount of infusion in the observation group were lower than those in the control group, and the first time of getting out of bed was shorter than that of the control group. The difference was statistically significant (P0.05); (4). There was no significant difference in the incidence of postoperative complications between the two groups (P0.05). Conclusion Ultrasound-guided femoral nerve block combined with general anesthesia can improve the stability of hemodynamics in patients with high ligation of the great saphenous vein and point exfoliation, and the analgesic effect is positive.
【作者单位】：江苏省常州市第二人民医院麻醉科;
【分类号】：R614

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