超声引导下外周神经阻滞对老年下肢动脉硬化闭塞症截肢术患者循环系统和疼痛的影响

目的:研究超声引导下外周神经阻滞对老年下肢动脉硬化闭塞症截肢术患者循环系统和疼痛的影响。方法:选择我院2016年2月～2019年11月收治的82例老年下肢动脉硬化闭塞症患者为研究对象,所有患者均接受下肢截肢术治疗,对照组采用硬膜外麻醉,研究组采用超声引导下外周神经阻滞。对比两组感觉神经、运动神经阻滞情况、阻滞效果,循环功能,疼痛指标和不良反应。结果:研究组感觉神经及运动神经阻滞起效时间较对照组短,感觉神经及运动神经阻滞维持时间较对照组长,差异比较有统计学意义(P0.05)。两组优良率差异比较无统计学意义(P0.05)。手术开始30 min时,对照组心率、平均动脉压均下降,研究组无明显改变,差异比较有统计学意义(P0.05)。术后24h时,两组疼痛指标浓度均较入室时增加,研究组低于对照组,差异比较有统计学意义(P0.05)。研究组不良反应总发生率低于对照组(P0.05)。结论:老年下肢动脉硬化闭塞症截肢术患者予以超声引导下外周神经阻滞的起效时间更快,能够减轻围术期疼痛,保持术中循环功能的稳定。

Effect of Ultrasound-guided Peripheral Nerve Block on Perioperative Stress Response of Elderly Patients Undergoing Amputation for Lower Limb Arteriosclerosis Obliterans

ABSTRACT Objective: To study the effect of ultrasound-guided peripheral nerve block on perioperative stress response in elderly patients with lower extremity arteriosclerosis obliterans undergoing amputation. Methods: 82 elderly patients with lower limb arteriosclerosis obliterans admitted to our hospital from February 2016 to November 2019 were selected as the research object. All patients were treated by lower limb amputation, the control group was treated with epidural anesthesia, and the research group was treated with ultrasound-guided peripheral nerve block. The sensory nerve and motor nerve block, block effect, circulation function, pain index and adverse reactions were compared between the two groups. Results: The onset time of sensory nerve and motor nerve block in the research group was shorter than that in the control group, and the maintenance time of sensory nerve and motor nerve block was longer than that of the control group leader, the difference was statistically significant (P<0.05). There was no significant difference in the excellent and good rates between the two groups (P>0.05). At the beginning of the operation for 30 min, heart rate and mean arterial pressure in the control group decreased, but there was no significant change in the research group, and the difference was statistically significant (P<0.05). At 24h after surgery, the pain index concentration in both groups increased compared with that at the time of entry, and the difference between the research group and the control group was statistically significant (P<0.05). The total incidence of adverse reactions in the research group was lower than that in the control group (P<0.05). Conclusion: The onset time of ultrasound-guided peripheral nerve block in elderly patients with lower extremity arteriosclerosis obliterans amputation is faster, which can reduce perioperative pain and maintain the stability of circulatory function during operation.