|
|
|
| Anesthetic Effects of Ultrasound-Guided Lumbosacral Plexus Nerve Block Combined with Propofol in Patients Undergoing Lower Limb Orthopedic Surgery |
| LIU Yangyang, LIU Yusheng, NIU Weikang |
| Department of Anesthesiology, Xinzheng Huaxin Minsheng Hospital, Xinzheng Henan 451100 |
|
|
|
|
Abstract 【Objective】 To investigate the anesthetic effects of ultrasound-guided lumbosacral plexus nerve block(PNS) combined with propofol in patients undergoing lower limb orthopedic surgery, and its influence on serum level of neurospecific protein S-100β.【Methods】 Ninety patients scheduled for lower limb orthopedic surgery were randomly divided into two groups:the observation group(n=45), which received ultrasound-guided PNS combined with propofol, and the control group(n=45), which received combined spinal-epidural anesthesia. Anesthetic effects, postoperative adverse reactions, and serum S-100β protein levels at different time points were compared between the two groups.【Results】 At 3, 6, 12, and 24 hours postoperatively, the visual analogue scale(VAS) pain scores in the observation group were significantly lower than those in the control group(P<0.05). The onset time of sensory nerve block was shorter in the observation group(P<0.05), while the duration of both sensory and motor nerve block in the observation group was longer than that in the control group(P<0.01). Mean arterial pressure at 10 minutes after anesthesia and 10 minutes after surgery were higher in the observation group(P<0.05). The incidence of adverse reactions was lower in the observation group compared to the control group. Serum S-100β protein levels at 30 minutes during surgery, and at 1 and 6 hours postoperatively, were significantly lower in the observation group(P<0.01).【Conclusion】 Ultrasound-guided PNS combined with propofol provides effective anesthesia for lower limb orthopedic surgery, with fewer adverse reactions and neurological complications. It is therefore worthy of clinical promotion.
|
|
Received: 06 December 2023
|
|
|
|
|
|
[1] 陈容,杨烨.超声引导下腰丛联合坐骨神经阻滞麻醉在老年患者下肢骨科手术中的应用价值评价[J].中国急救医学,2018,38(1):121.
[2] 何维海,戚洪亮.超声引导下腰丛-坐骨神经阻滞联合丙泊酚在股骨粗隆间骨折手术中的应用[J].颈腰痛杂志,2019,40(4):505-507.
[3] 赵姝,张海光.异丙酚复合瑞芬太尼联合超声引导下胸椎旁神经阻滞在老年肺癌改良根治术中的应用效果[J].重庆医学,2020,49(14):2351-2354.
[4] GONEN M, OZDOGAN S, BALGETIE F, et al. S100B and neuron-specific enolase levels in episodic and chronic migraine[J].Acta Neurol Scand,2021,143(3):298-302.
[5] 吴孟超,吴在德.黄家驷外科学[M].8版. 北京:人民卫生出版社, 2021:254.
[6] 张庆华,马鑫笛,廖华山. 腰丛联合坐骨神经阻滞复合丙泊酚在老年骨科手术患者麻醉中的应用[J].医学临床研究,2018,35(2):388-390.
[7] 刘涛,刘兆东. 超声引导下腰骶丛神经阻滞对老年髋关节置换术后认知功能及血清应激、炎症指标的影响[J].国际精神病学杂志,2023,50(1):128-131.
[8] 鲍淑敏,王立宪,单士强.超声引导下连续椎旁神经阻滞对老年食管癌手术患者术后恢复的影响[J].中国医药导报,2019,16(1):110-113.
[9] TAMMAM T F. Ultrasound-guided infragluteal sciatic nerve block:a comparison between four different techniques[J].Acta Anaesthesiol Scand,2013,57(2):243-248.
[10] 张晶,张为民,朱耀斌,等.异丙酚和尼莫地平在婴幼儿体外循环心脏手术中脑保护作用[J].中华实用诊断与治疗杂志,2017,31(4):350-353.
[11] 许杰,王晖,温洪,等. 异丙酚对缺氧/复氧诱导PC12细胞损伤的影响及其分子机制[J].中国医药导报,2023,20(16):31.
[12] 张元会,李晓龙.异丙酚与右美托咪定在脑胶质瘤切除术中的脑保护效应对比[J].实用癌症杂志,2019,34(6):923-925.
[13] 彭春潮,吴婧文,光文辉,等.局部浸润联合丙泊酚静脉麻醉对老年髋部骨折手术患者认知功能的影响[J].中国医药,2019,14(10):1562-1565.
[14] PAPA L, MITTAL M K, RAMIREZ J, et al. In children and youth with mild and moderate traumatic brain injury, glial fibrillary acidic protein out-performs S-100β in detecting traumatic intracranial lesions on computed tomography[J].J Neurotrauma,2016,33(1):58-64.
[15] YUAN S M. S100 and S-100β:biomarkers of cerebral damage in cardiac surgery with or without the use of cardiopulmonary bypass[J].Rev Bras Cir Cardiovasc,2014,29(4):630-641. |
| [1] |
. [J]. JOURNAL OF CLINICAL RESEARCH, 2025, 42(9): 1639-1641. |
|
|
|
|
2025, Vol. 42 
