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超声引导腰丛阻滞并右美托咪定麻醉在高龄髋关节置换术中的应用观察
作者:姚倩娟  刘松华  李琼灿 
单位:湖南省长沙市中心医院 麻醉科, 湖南 长沙 410008
关键词:腰丛阻滞 布比卡因 罗哌卡因 右美托咪定 
分类号:R687.4
出版年·卷·期(页码):2020·39·第一期(6-10)
摘要:

目的: 探讨超声引导腰丛阻滞并右美托咪定在高龄患者髋关节置换术中的应用效果。方法: 选取我院收治的高龄髋关节置换患者40例,并随机分为对照组和观察组,每组各20例。对照组使用0.3%的罗哌卡因腰丛阻滞联合布比卡因腰麻,观察组使用0.3%的罗哌卡因和右美托咪定腰丛阻滞联合布比卡因腰麻;比较不同时刻患者的心率、血压和VAS评分。此外,比较两组患者的改良Bromage评分和不良反应发生情况。方法: 观察组患者MAP和HR在T1-T4时刻均低于对照组,差异有统计学意义(P<0.05);观察组在T6、T7时的VAS评分均低于对照组,且观察组患者的改良Bromage评分显著低于对照组,差异有统计学意义(P<0.05);此外,两组患者不良反应发生率没有统计学意义(P<0.05)。方法: 0.3%的罗哌卡因联合右美托咪定进行腰丛阻滞,同时使用等比重布比卡因进行腰麻对患者血压和心率影响最小,患者术后运动阻滞恢复快,值得临床推广。

Objective: To explore the effect of ultrasound-guided lumbar plexus block and dexmedetomidine in elderly patients undergoing hip arthroplasty. Methods: 40 cases of elderly hip arthroplasty in our hospital were selected and randomly divided into control group and observation group, 20 cases in eachs. The control group received 0.3% ropivacaine lumbar plexus block combined with bupivacaine for spinal anesthesia. The observation group was treated with 0.3% ropivacaine and dexmedetomidine lumbar plexus block combined with bupivacaine for lumbar anesthesia. The heart rate, blood pressure and VAS score of patients at different times were compared. In addition, the improvement of Bromage score and incidence of adverse reactions were compared between the two groups. Results: The MAP and HR of the observation group were lower than those of the control group at the time of T1-T4 (P<0.05). The VAS score of the observation group at T6 and T7 was lower than that of the control group, and the improved Bromage score of the observation group was significantly lower than that of the control group (P<0.05). In addition, there was no significant difference in the incidence of adverse reactions between the two groups (P<0.05). Conclusion: 0.3% ropivacaine combined with dexmedetomidin for lumbar plexus block, while using the equal specific gravity bupivacaine for lumbar anesthesia has the the least effect on blood pressure and heart rate, and the recovery of the postoperative movement block is fast and the adverse reaction is less. It is worthy of clinical promotion.

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