超声引导下神经阻滞复合全身麻醉对全膝关节置换术患者镇痛效果及血流动力学的影响

Abstract
Figure/Table
References (19)
Related Citation (15)

Download: PDF (856 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract

Objective To analyze the effect of ultrasound-guided nerve block combined with general anesthesia on analgesia and hemodynamics in patients with total knee replacement. Methods A total of 80 patients with total knee replacement treated in Longyan First Hospital Affiliated to Fujian Medical University from January 2019 to June 2021 were selected as the research objects. They were divided into control group (n=40) and observation group (n=40) by random number table method. The control group were treated with general anesthesia, and the observation group were treated with ultrasound-guided lumbar plexus sciatic nerve block combined with general anesthesia. The visual analogue scale (VAS) score, analgesic situation, anesthetic dosage and hemodynamic changes were compared between the two groups. Results The heart rate and mean artery pressure of the observation group during intubation and extubation were higher than those of the control group, the differences were statistically significant (P<0.05). The VAS score of the observation group was lower than that of the control group, the time from the first demand for patient-controlled analgesia pump (PCA) to conscious extubation was longer than that of the control group, the recovery time of anesthesia was shorter than that of the control group, the pressing times of analgesia pump and the use of Sufentanil within 24 hours after operation were less than those of the control group, and the score of patients' satisfaction with analgesia was higher than that of the control group, the differences were statistically significant (P<0.05). The doses of Propofol, Remifentanil and Sufentanil in the observation group were lower than those in the control group, the differences were statistically significant (P<0.05). There was no significant difference in anesthesia time between the two groups (P＞0.05). The recovery time and extubation time of the observation group were shorter than those of the control group, the differences were statistically significcant (P<0.05). Conclusion Using ultrasound-guided nerve block combined with general anesthesia can maintain stable hemodynamics and have good analgesic effect. It can effectively reduce patients' pain and reduce the dosage of narcotic analgesics. It has high application value.

Key words： Ultrasonic-guided nerve block General anesthesia Total knee replacement Hemodynamics

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors

Cite this article:

URL:

https://www.dangdaiyiyao.com/EN/ OR https://www.dangdaiyiyao.com/EN/Y2022/V29/I18/115

[1]	Wainwright TW，Gill M，McDonald DA，et al.Consensus statement for perioperative care in total hip replacement and total knee replacement surgery：Enhanced Recovery After Surgery （ERASR） Society recommendations[J].Acta Orthop，2020，91（1）：3-19.
[2]	Soleimani M，Barkhordari S，Mardani F，et al.Rationing access to total hip and total knee replacement in the Islamic Republic of Iran to reduce unnecessary costs：policy brief[J].East Mediterr Health J，2020，26（11）：1396-1402.
[3]	Liao CD，Tsauo JY，Chiu YS，et al.Effects of Elastic Resistance Exercise After Total Knee Replacement on Muscle Mass and Physical Function in Elderly Women With Osteoarthritis：A Randomized Controlled Trial[J].Am J Phys Med Rehabil，2020，99（5）：381-389.
[4]	陈帆，柴小青，王迪，等.单侧全膝关节置换术后急性疼痛的危险因素[J].中华麻醉学杂志，2020，40（11）：1328-1331.
[5]	陈建华，刘建东，张镇城.超声定位下神经阻滞麻醉结合浸润麻醉用于行全膝关节置换术的膝关节骨性关节炎患者中的临床效果观察[J].临床和实验医学杂志，2020，19（5）：556-559.
[6]	张晓平，赵建奎.腰丛联合坐骨神经阻滞麻醉对全膝关节置换术患者的血流动力学及应激状况的影响[J].海南医学，2019，30（24）：3216-3219.
[7]	侯晓玲，谢小伟，涂晓晴，等.加速康复下全膝关节置换术后急性疼痛多因素分析及对策[J].四川医学，2018，39（4）：379-382.
[8]	岑艳芳，毛鑫城.连续股神经——坐骨神经阻滞复合全身麻醉在全膝关节置换术中的应用效果[J].广西医科大学学报，2020，37（1）：99-103.
[9]	贺海欧.高龄全膝关节置换中全麻和硬膜外麻醉对凝血功能的影响[J].现代中西医结合杂志，2018，27（2）：209-211.
[10]	侯晓玲，罗泽宇，王浩洋，等.收肌管阻滞麻醉联合局部浸润麻醉镇痛对初次人工全膝关节置换术后康复的影响[J].中国修复重建外科杂志，2018，32（8）：39-44.
[11]	孙振和，刘丹，刘罡.术前股神经阻滞对全身麻醉下全膝关节置换术老年患者的超前镇痛效果观察[J].山西医药杂志，2018，47（1）：63-65.
[12]	张怀奇，李贺，李琼，等.超声引导收肌管阻滞联合膝关节后方浸润麻醉用于全膝关节置换手术的疗效观察[J].临床外科杂志，2018，26（8）：57-59.
[13]	王绍廷.局部浸润麻醉和股骨神经阻滞对改善全膝关节置换术后疼痛的效果对比[J].中国急救医学，2018，38（z1）：98.
[14]	贺克强，谢言虎，凡小庆，等.右美托咪啶复合罗哌卡因在超声引导下股神经阻滞对全膝关节置换术后局部炎性反应及镇痛效果的影响[J].中国临床保健杂志，2018，21（1）：68-71.
[15]	胡玲，康路，王瑞婷，等.超声引导下收肌管联合IPACK阻滞在老年患者全膝关节置换术中的应用[J].实用医学杂志，2020，36（7）：950-953.
[16]	夏晴，邓建华，陈永红，等.股神经阻滞技术对全膝关节置换术后关节疼痛及康复的影响[J].江苏医药，2018，44（11）：1306-1308.
[17]	韦宁华，王波.超声引导下神经阻滞复合全身麻醉对老年全膝关节置换术患者镇痛效果及血流动力学的影响[J].中国煤炭工业医学杂志，2020，23（6）：109-112.
[18]	任普圣，李林佶，姜丹，等.超声引导下神经阻滞复合喉罩全身麻醉对老年髋关节置换手术患者血流动力学的影响[J].实用临床医药杂志，2018，22（17）：53-56，60.
[19]	王芳.老年全膝关节置换术患者术后镇痛中超声引导下连续股神经阻滞的应用效果及对患者血流动力学的影响[J].中国医学创新，2021，18（18）：139-142.