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髂筋膜间隙阻滞联合艾司氯胺酮静脉全身麻醉在老年患者PFNA手术中的应用:一项前瞻性、单中心、对照试验。

The application of iliac fascia space block combined with esketamine intravenous general anesthesia in PFNA surgery of the elderly: A prospective, single-center, controlled trial.

作者信息

Jia Xuandong, Liao Xingzhi, Zhou Maitao

机构信息

Department of Anesthesiology, The 904th Hospital of the Joint Logistic Support Force of PLA, Wuxi 214000, Jiangsu Province, China.

出版信息

Open Med (Wars). 2023 Aug 31;18(1):20230783. doi: 10.1515/med-2023-0783. eCollection 2023.

Abstract

To observe the effect of iliac fascia space block combined with esketamine intravenous general anesthesia in proximal femoral nail antirotation (PFNA) of the elderly. Eighty elderly patients who underwent PFNA were randomly divided into experimental group and control group. In the experimental group, iliac fascial block combined with esketamine and propofol intravenous general anesthesia was used to keep spontaneous breathing. The control group used iliac fascia block combined with remifentanil and propofol intravenous general anesthesia to maintain spontaneous breathing. Record important indexes such as heart rate (HR), mean arterial pressure (MAP), pulse oxygen saturation (SpO), visual analogue score (VAS) scores, etc. at different moment during the operation. Trial data showed that there were significant differences in HR, MAP, and SpO between the two groups at the beginning of operation, and there was no significant difference in VAS scores between the two groups at each moment after surgery, and there were significant differences in the number of vasopressor applications, length of hospital stay, and QoR-15 scores between the two groups, and there were significant differences in the incidence of total adverse reactions and the incidence of hypotension. The trial indicated that patients in the experimental group have more stable hemodynamics and lower stress response, which is conducive to rapid recovery after surgery.

摘要

观察髂筋膜间隙阻滞联合艾司氯胺酮静脉全身麻醉在老年股骨近端防旋髓内钉(PFNA)手术中的效果。将80例行PFNA手术的老年患者随机分为实验组和对照组。实验组采用髂筋膜阻滞联合艾司氯胺酮及丙泊酚静脉全身麻醉并保留自主呼吸。对照组采用髂筋膜阻滞联合瑞芬太尼及丙泊酚静脉全身麻醉并保留自主呼吸。记录手术中不同时刻的重要指标,如心率(HR)、平均动脉压(MAP)、脉搏血氧饱和度(SpO)、视觉模拟评分(VAS)等。试验数据显示,两组在手术开始时HR、MAP和SpO有显著差异,术后各时刻两组VAS评分无显著差异,两组血管活性药物应用次数、住院时间和QoR-15评分有显著差异,总不良反应发生率和低血压发生率有显著差异。试验表明,实验组患者血流动力学更稳定,应激反应更低,有利于术后快速恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ad8/10487396/b56661c41cd8/j_med-2023-0783-fig001.jpg

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