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机构地区:[1]首都医科大学燕京医学院附属密云医院,101500
出 处:《中国实用医药》2011年第13期13-14,共2页China Practical Medicine
摘 要:目的评价在老年单侧髋关节置换术中采用腰丛神经阻滞复合浅全麻的麻醉效果及对患者血流动力学的影响。方法选择55例ASAⅡ~Ⅲ级行髋关节置换术的老年患者,55例患者围术期均行抗凝治疗。先行右颈内静脉穿刺,连续监测中心静脉压(CVP),再行腰丛神经阻滞麻醉。在充分的表面麻醉和全麻诱导后行气管插管,观察患者血压(NIBP)、心率(HR)、脉搏血氧饱和度(SPO2)、CVP变化及术毕苏醒时间。结果 55例患者术中及术毕拔管时血压及心率保持在腰丛神经阻滞后水平(P>0.05),而明显低于入室血压和心率(P<0.05),术中CVP明显高于入室水平(P<0.05),SPO2保持在97~99左右,术毕清醒时间为5~10min。结论老年髋关节置换术采用腰丛神经阻滞复合浅全麻,术中血流动力学平稳,术毕清醒时间短。Objective To evaluate the anesthetic effect of elderly patients during unilateral hip replacement in the lumbar plexus block combined with light general anesthesia and effect of hemodynamic on patients.Methods Select 55 elderly patients of ASA Ⅱ~Ⅲ grade in hip replacement and preoperative anticoagulant therapy were performed.Right jugular vein puncture under local anesthesia and continuous monitoring of central venous pressure(CVP) and lumber plexus block were performed in order.Tracheal intubation was performed after full surface anesthesia and induction of general anesthesia.Continuous monitoring of blood pressure(BP)、heart rate(HR) pulse oxygen saturation(SPO2),CVP and recovery time after operation were observed.Results 55 patients' BP and HR during operation and after extubation maintained stability in comparison with lumbar plexus block(P0.05),lower than the level of the patients' BP and HR when the patients entered operating room(P0.05).CVP during operation were higher than the level of entering operating room(P0.05).SPO2 maintained at 97%~99%.recovery time was for 5~10 minutes.Conclusion Elderly hip replacement are performed in lumbar plexus block combined with light general anesthesia.intraoperative hemodynamic is stable and the time of recovery was short.
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