腰-硬联合麻醉在老年患者关节置换术的临床观察  

The clinical observation of combined spinal-epidural anesthesia for joint replacement in elderly patients

作　　者：涂远光[1] 李平[1] 

机构地区：[1]广东梅州市嘉应学院医学院附属医院麻醉科,梅州514031

出　　处：《河南外科学杂志》2011年第3期10-12,共3页Henan Journal of Surgery

摘　　要：目的探讨老年患者人工关节置换术安全有效的麻醉方法。方法 将120例70岁以上接受人工关节置换术的老年患者随机分为硬膜外组(A组)、腰-硬联合麻醉组(B组)。术中按6～10 mL/(kg.h)输中分子羟乙基淀粉130/0.4氯化钠注射液和复方乳酸钠林格注射液(1:1)。观察A组和B组局麻药用量、感觉阻滞起效时间、阻滞平面、阻滞完善时间。同时观察2组的麻醉效果、镇痛效果、血流动力学及不良反应。结果B组感觉阻滞起效时间、阻滞完善时间明显快于A组(P<0.05),B组麻醉效果优于A组(P<0.05)。结论腰-硬联合麻醉起效快、成功率高、效果确切,是老年患者全髋置换术中较为理想的麻醉方法。Objective To study a kind of less medication,blood pressure more stable,more safe and effective method of anesthesia for patients over 70 years old with prosthetic replacement for joint.Methods 120 elderly patients over 70 years old with prosthetic replacement for joint,were randomly divided into epidural anesthesia group（A group）,combined spinal-epidural anesthesia group（B group）.Intraoperative infusion by 6-10ml/（kg h）with compound sodium lactate and HES（1∶1）,in A groupand B group local anesthetic dosage,onset time of sensory block,levels of anesthesia and complete block of time were observed,at the same time observed anesthesia effect,analgesic effect,hemodynamics and adverse reactions of two groups.Results The onset time of sensory block and complete block of time of B group were faster than those of A group（P 0.01or P0.05）,anesthesia effect of B group was better than those of A group（P0.05）.Conclusion The combined spinal-epidural anesthesia for prosthetic replacement for joint in elderly patients is safe and effective anesthesia,as long as good control of anesthesia and intraoperative careful management.

关 键 词：腰-硬联合麻醉 人工关节置换术 老年 

分 类 号：R687.4[医药卫生—骨科学]