区域神经阻滞麻醉在股骨粗隆间骨折手术中的应用效果

doi:10.3969/j.issn.2095-9400.2021.06.012

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Abstract Objective: To investigate the effect of regional nerve block anesthesia in the operation of intertrochanteric fracture. Methods: Clinical data of 75 patients with intertrochanteric fracture who underwent operation from Mar. 2020 to Dec. 2020 in Wenzhou Central Hospital were retrospective analyzed. They were divided into two groups:the regional nerve block anesthesia group (n=34) that underwent combined block anesthesia of lumbar plexus nerve, femoral nerve or lateral femoral cutaneous nerve, and the control group (n=41) that underwent spinal anesthesia. A comparison was made between the two groups in intraoperative and 2, 4, 8 h
postoperative VAS scores, albumin level, the incidence of postoperative complications (hypotension, delirium, uroschesis), ADL scores, hospitalization time and the cost of hospitalization. Results: Intraoperative and 2, 4, 8 h postoperative VAS scores and the decrease of albumin [(4.47±2.36)g/L vs. (6.52±2.34)g/L] in regional nerve block anesthesia group were significantly lower than those in the control group (P<0.05). The arterial pressure of the two groups has no significance before anesthesia [(101.6±8.1)mmHg vs. (104.2±9.1)mmHg], but during the operaiton of skin incision, 20 min and 40 min, it decreased slightly [(103.2±9.1)mmHg vs. (93.8±8.2)mmHg, (100.9±8.3)mmHg vs. (91.9±7.1)mmHg, (97.9±7.2)mmHg vs. (91.8±5.8)mmHg, P<0.05]. Compared with control group, lower incidence of postoperative hypotension (5.88% vs. 26.83%) was found, but there was no significant difference in the incidence of postoperative delirium (5.88% vs. 12.20%) and postoperative uroschesis (8.82% vs. 19.51%) between the two groups. ADL scores were higher in regional nerve block anesthesia group than those in control group [(26.9±4.4) vs. (21.3±2.5), P<0.05]. Hospitalization time [(11.1±3.7)d vs. (14.8±9.4)d] and the cost of hospitalization [(27 142.5±5 676.0)yuan vs. (31 828.7±9 065.4)yuan] were better in regional nerve block anesthesia group (P<0.05). Conclusion: Regional nerve block anesthesia in the operation of intertrochanteric fracture has better analgesic effect in that it reduces the negative nitrogen balance, hospitalization time and the cost of hospitalization, and also accelerates postoperative recovery.

Key words： regional nerve block anesthesia intertrochanteric fracture local anesthesia delirium

Received: 05 January 2021

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	ZHENG Junju
	CHEN Jiaru
	LIN Zhou
	LIN Fan
	ZHOU Guang
	HAN Xiaodong

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https://xb.wmu.edu.cn/EN/10.3969/j.issn.2095-9400.2021.06.012 OR https://xb.wmu.edu.cn/EN/Y2021/V51/I6/491

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