Shi Zheng-Yuan, Jiang Chun-Nan, Shao Gang
Department of Anesthesiology, People's Hospital of Danyang, Jiangsu, China.
Medicine (Baltimore). 2018 Oct;97(40):e12581. doi: 10.1097/MD.0000000000012581.
This study aims to evaluate the effectiveness and safety of lower limb nerve block combined with slow induction of light general anesthesia and tracheal intubation in hip surgery in the elderly.
Thirty elderly patients who underwent hip surgery under the lower limb nerve block were randomly divided into 2 groups: slow induction of light general anesthesia and tracheal intubation group (group M), and laryngeal mask light general anesthesia group (group H). After undergoing total intravenous anesthesia without muscle relaxants, all patients received sciatic nerve, lumbar plexus, and paravertebral nerve blocks. The hemodynamic situations, dosage of anesthetics, time for awakening and extubation (or laryngeal mask removal), and incidence of respiratory adverse reactions in the induction period were recorded.
Compared with baseline levels, the difference in mean arterial pressure (MAP) value at each time point after intubation/laryngeal mask removal in both groups was not statistically significant (P > .05). Furthermore, the time for awakening and extubation/laryngeal mask removal, and anesthetic dosage were significantly decreased in group M, when compared with group H (P < .05). For the incidence of adverse reactions, the incidence of poor sealing and hypoxia was significantly lower in group M than in group H (P < .05), and the incidence of sore throat was significantly lower in group H than in group M (P < .05).
Lower limb nerve block combined with slow induction of light general anesthesia and tracheal intubation was associated with smaller anesthetic dosage, and shorter duration of anesthesia induction and extubation/laryngeal mask after surgery.
本研究旨在评估老年髋关节手术中下肢神经阻滞联合浅全麻慢诱导气管插管的有效性和安全性。
30例行下肢神经阻滞髋关节手术的老年患者随机分为2组:浅全麻慢诱导气管插管组(M组)和喉罩浅全麻组(H组)。所有患者在未使用肌肉松弛剂的全静脉麻醉下接受坐骨神经、腰丛神经和椎旁神经阻滞。记录诱导期的血流动力学情况、麻醉药用量、苏醒和拔管(或拔除喉罩)时间以及呼吸不良反应发生率。
与基础水平相比,两组插管/拔除喉罩后各时间点平均动脉压(MAP)值差异无统计学意义(P>0.05)。此外,与H组相比,M组的苏醒和拔管/拔除喉罩时间以及麻醉药用量显著降低(P<0.05)。关于不良反应发生率,M组密封不良和低氧发生率显著低于H组(P<0.05),H组咽痛发生率显著低于M组(P<0.05)。
下肢神经阻滞联合浅全麻慢诱导气管插管麻醉药用量较小,术后麻醉诱导和拔管/拔除喉罩时间较短。