Application of lung-protective ventilation combined with general anesthesia and femoral nerve and lateral femoral cutaneous nerve block in elderly patients undergoing total knee arthroplasty

LUO Ying; ZHOU Hui-peng; SONG Xin; LIU Chong; WANG Wei

doi:10.11659/jjssx.08E025095

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Application of lung-protective ventilation combined with general anesthesia and femoral nerve and lateral femoral cutaneous nerve block in elderly patients undergoing total knee arthroplasty

Clinical Research | 更新时间：2026-04-20

- Application of lung-protective ventilation combined with general anesthesia and femoral nerve and lateral femoral cutaneous nerve block in elderly patients undergoing total knee arthroplasty
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 35, Issue 4, Pages: 350-353(2026)
- 作者机构：
  
  1.第九六四医院麻醉科，吉林长春 130000
  2.吉林省前卫医院麻醉科，吉林长春 130000
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.08E025095
  CLC： R614.2
- Received：25 August 2025，
  
  Published：25 April 2026
- 稿件说明：
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罗莹,周慧鹏,宋鑫等.肺保护性通气结合全麻复合股神经、股外侧皮神经阻滞在老年全膝关节置换术中的应用[J].局解手术学杂志,2026,35(04):350-353.

LUO Ying,ZHOU Hui-peng,SONG Xin,et al.Application of lung-protective ventilation combined with general anesthesia and femoral nerve and lateral femoral cutaneous nerve block in elderly patients undergoing total knee arthroplasty[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(04):350-353.
罗莹,周慧鹏,宋鑫等.肺保护性通气结合全麻复合股神经、股外侧皮神经阻滞在老年全膝关节置换术中的应用[J].局解手术学杂志,2026,35(04):350-353. DOI： 10.11659/jjssx.08E025095.

LUO Ying,ZHOU Hui-peng,SONG Xin,et al.Application of lung-protective ventilation combined with general anesthesia and femoral nerve and lateral femoral cutaneous nerve block in elderly patients undergoing total knee arthroplasty[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(04):350-353. DOI： 10.11659/jjssx.08E025095.

摘要

目的

探讨肺保护性通气结合全麻复合股神经阻滞（FNB）、股外侧皮神经阻滞（LFCNB）在全膝关节置换术（TKA）老年患者中的应用效果。

方法

选择第九六四医院2022年9月至2024年7月收治的82例TKA老年患者进行回顾性研究，根据不同干预方案分为观察组与对照组，每组41例。2组患者均给予全麻复合FNB、LFCNB，对照组联合常规通气管理，观察组联合肺保护性通气管理。比较2组患者治疗参数，麻醉前（T0）、诱导后5 min（T1）、手术开始时（T2）、手术结束时（T3）的血流动力学参数[平均动脉压（MAP）、心率（HR）]，通气前、通气结束后即刻的呼吸氧合功能[氧合指数（OI）、气道峰压（Ppeak）、气道平台压（Pplat）、呼气末正压（PEEP）、静态肺顺应性]，术后肺部并发症发生情况。

结果

2组患者手术时间、术中出血量、输液量及舒芬太尼用量比较，差异均无统计学意义（

0.05）。2组患者T1、T2的MAP、HR均较T0降低（

0.05），且观察组患者T1、T2的MAP、HR降低幅度均小于对照组（

0.05）。2组患者通气结束后的OI、PEEP、静态肺顺应性均较通气前降低（

0.05），Ppeak、Pplat较通气前升高（

0.05），且观察组患者通气结束后的OI、PEEP、静态肺顺应性降低幅度及Ppeak、Pplat升高幅度均小于对照组（

0.05）。观察组患者术后肺部并发症总发生率低于对照组，差异有统计学意义（

0.05）。

结论

肺保护性通气结合全麻复合FNB、LFCNB应用于TKA老年患者，可改善患者呼吸氧合功能，维持术中血流动力学稳定，降低术后肺部并发症发生风险，临床应用效果显著。

Abstract

Objective

To investigate the application effect of lung-protective ventilation combined with general anesthesia and femoral nerve block （FNB） and lateral femoral cutaneous nerve block （LFCNB） in elderly patients undergoing total knee arthroplasty （TKA）.

Methods

A retrospective study was conducted on 82 elderly patients undergoing TKA admitted to the 964th Hospital from September 2022 to July 2024. The patients were divided into the observation group and the control group according to different intervention protocols， with 41 cases in each group. Patients in both groups received general anesthesia combined with FNB and LFCNB. The control group received conventional ventilation management， while the observation group received lung-protective ventilation management. The treatment parameters， hemodynamic parameters ［mean arterial pressure （MAP）， heart rate （HR）］ before anesthesia （T0）， 5 minutes after induction （T1）， at the start of surgery （T2）， and at the end of surgery （T3）， respiratory oxygenation function ［oxygenation index （OI）， peak airway pressure （Ppeak）， plateau airway pressure （Pplat）， positive end-expiratory pressure （PEEP）， and static lung compliance］ before ventilation and immediately after ventilation， and the incidence of postoperative pulmonary complications were compared between the two groups of patients.

Results

There was no statistically significant difference in surgical time， intraoperative blood loss， infusion volume， or sufentanil dosage between the two groups of patients （

0.05）. The MAP and HR at T1 and T2 in both groups were lower than those at T0 （

0.05）， and the decreases of MAP and HR in the observation group were smaller than those in the control group （

0.05）. After ventilation， the OI， PEEP， and static lung compliance in both groups were lower than those before ventilation （

0.05）， while the Ppeak and Pplat were higher than those before ventilatio

n （

0.05）. The decreases of OI， PEEP， and static lung compliance and the increases of Ppeak and Pplat after ventilation in the observation group were all smaller than those in the control group （

0.05）.The total incidence of postoperative pulmonary complications in the observation group was lower than that in the control group （

0.05）.

Conclusion

The application of lung-protective ventilation combined with general anesthesia and FNB and LFCNB in elderly patients undergoing TKA can improve respiratory oxygenation function， maintain intraoperative hemodynamic stability， and reduce the risk of postoperative pulmonary complications， with remarkable clinical efficacy.

关键词

Keywords

references

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