高位肌間溝羅哌卡因神經阻滯用于老年鎖骨骨折麻醉效果及其對應激反應影響

劉文祎

[關鍵詞] 高位肌間溝;神經阻滯;羅哌卡因;老年鎖骨骨折;應激反應

[中圖分類號] R614? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 1673-9701（2021）21-0107-04

Anesthesia effect of ropivacaine nerve block in the high intermuscular groove for elderly clavicle fractures and its influence on the stress response

LIU Wenyi

Department of Anesthesiology， Dalian Pulandian Central Hospital， Dalian? ?116200， China

[Abstract] Objective To investigate the anesthesia effect of ropivacaine nerve block in the high intermuscular groove for elderly clavicle fractures and its influence on the stress response. Methods A total of 150 elderly patients undergoing clavicular fracture surgery admitted to the Dalian Pulandian Central Hospital from December 2018 to December 2019 were selected and randomLy divided into the control group and the observation group， with 75 cases in each group. The control group was given conventional intermuscular sulcus brachial plexus block anesthesia. The observation group was given ropivacaine nerve block anesthesia in the upper intermuscular groove. The anesthesia effect， stress response， postoperative pain， and complication rate of the two groups were compared. Results The excellent and good rate of anesthesia in the observation group was 100.0%， which was higher than 93.33% in the control group. The SVI （45.93±8.78） mL/m2， MAP （82.59±19.52） mmHg， HR （64.93±8.78） times/min of the observation group was higher than SVI （38.84±13.67） mL/m2， MAP（74.62±6.78） mmHg，HR（60.84±6.67） times/min of the control group after anesthesia. The observation group's CI （2.83±0.54）L/（min·m2）， MAP （82.53±12.54）mmHg， HR （67.53±8.54）times/min was higher than CI （2.52±0.52） L/（min·m2）， MAP （76.53±10.54）mmHg，HR（60.53±4.54）times/min of the control group 1h after surgery. The postoperative 2 h VAS score （3.07±1.02）points， postoperative 6h VAS score （3.00±0.34）， postoperative 12 h VAS score （2.95±0.14） points， postoperative 24 h VAS score （1.85±0.22） in the observation group were lower than the postoperative 2 h VAS score （3.68±1.21） points， 6 h VAS score （3.27±0.26） points， 12 h VAS score （3.13±0.25）points，and 24 h VAS score （2.51±0.26）points of the control group.The incidence of complications in the observation group was 9.33%， which was lower than 21.33% in the control group（P<0.05）. Conclusion The high intermuscular groove ropivacaine nerve block in elderly patients with fracture surgery has a better anesthesia effect and reduces the patient's stress response.