| Objective:To explore the effectiveness and safety of esketamine for relieving pain in patients with femoral fractures when placed in spinal anesthesia,in order to provide a basis for the choice of clinical analgesia.Methods: A total of 61 patients undergoing femoral fracture surgery under spinal anesthesia were selected and randomly divided into three groups,esketamine group(group A,n=20),iliac fascia block group(group B,n=21),physiology Saline group(group C,n=20).10 minutes before the posture,group A was given intravenous injection of esketamine 0.15mg/Kg(diluted to 10ml);group B was given 0.33%ropivacaine(30ml)for iliac fascia block;group C was given intravenous injection of 0.9% Sodium chloride injection 10 ml.Record the patient’s blood pressure,heart rate,finger pulse oxygen saturation,VAS score after entering the operating room(T1),10 minutes after the operation(T2),at the end of the posture(T3),and 5 minutes at the end of the puncture operation(T4);Analyze the operation time of spinal anesthesia and the number of successful cases of one-time puncture in each group of patients;record the occurrence of adverse reactions of patients;score the cooperation of patients,and allow patients to evaluate their satisfaction with anesthesia.Results: 1.There was no statistical difference in the patient’s baseline data.2.Vital signs: At T3 time,the MAP of group A was lower than that of group C,which was statistically significant(p <0.05);at time T3,the MAP of group B was lower than that of group C,and there was a statistical difference between the two groups(p <0.05).3.Pain score(VAS score)comparison(1)Comparison between groups: T2 and T3,the VAS scores of group A and B are lower than those of group C,and the difference between groups is statistically significant(p <0.05);at T3,the VAS score of group A is higher than that of group B,There are statistical differences(p <0.05).(2)Comparison within groups: Group A,Group B,and Group C were compared at the time points of T1,T2,and T3,and there was no statistical difference within each group;4.Comparison of cooperation scores: The cooperation score of group A is higher than that of group C,and the difference is statistically significant;the cooperation score of group B is higher than that of group C,and the difference is statistically significant;the cooperation score of group A is slightly lower than that of group B,and the difference between the two groups There is statistical significance.5.Comparison of the number of successful one-time puncture cases of combined rigid lumbar anesthesia for the three groups of patientsCompared with group C,group A had more successful puncture cases,and the difference was statistically significant(p <0.05);group B had more successful puncture cases than group C,and the difference was statistically significant(p <0.05).6.Comparison of operation time of spinal anesthesia in the three groups of patientsThe operation time of spinal anesthesia in group A was shorter than that in group C,and the difference between group A and group C was statistically significant(p <0.05).The operation time of group B patients was shorter than that of group C patients,and the difference between the two was significant(p <0.05).The operation time of group B patients was shorter than that of group A patients,and the difference between the two was significant(p <0.05).7.Satisfaction scores of the three groups of patients for the entire anesthesia processThe satisfaction of group A was higher than that of group C,and there was a statistical difference(p <0.05);the satisfaction of group B was higher than that of group C,and there was a statistical difference(p<0.05).8.Comparison of adverse reactions in the three groupsAfter comparison,there was no statistical difference in adverse reactions among the three groupsConclusion: Before orthopedic femoral fracture patients are placed for anesthesia,intravenous administration of esketamine at 0.15mg/kg can relieve the pain and discomfort caused by the patient’s positioning,improve patient compliance,and shorten the operation time of spinal anesthesia,Improve the success rate of puncture.But the effect is not as good as iliac fascia block. |
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