腰-硬联合麻醉用于老年股骨头置换术临床评价  

The waist an epidural anesthesia for elderly femoral head replacement surgery in clinical evaluation

作　　者：朱永霞[1] 

机构地区：[1]河南省商丘市第一人民医院麻醉科,476100

出　　处：《中国实用医药》2012年第34期10-11,共2页China Practical Medicine

摘　　要：目的探讨腰-硬联合麻醉用于老年股骨头置换术临床应用评价。方法 2010年1月至2012年1月进行老年股骨头置换术患者169例,分为腰-硬联合麻醉组85例,硬膜外麻醉组84例,观察对呼吸循环功能及麻醉效果。结果两组病例在给药前、给药10min、给药30min、术毕呼吸循环功能统计并比较,差异无统计学意义(P>0.05)。两组病例感觉、运动阻滞起效时间、阻滞完全时间、痛觉恢复时间及局麻药用量比较,差异有统计学意义(P<0.05)。结论老年人患者由于年老脏器功能下降储备能力差,对麻醉和手术耐受能力下降,合并症多,容易发生呼吸、循环抑制,对麻醉方法的选择较为困难;全麻易于呼吸管理,氧合充分,但老年患者肝肾功能减退,药物代谢及清除减慢,出现药物蓄积,容易出现苏醒延迟等。腰-硬联合麻醉(CSEA)是集腰麻、硬膜外麻醉两者之长,具有麻醉起效快、肌松效果良好,采用小剂最局麻药既可以达到良好的麻醉平面控制,对老年患者循环呼吸功能影响较小,更安全可靠。Objective To explore the the waist an epidural anesthesia used for the elderly femoral head arthroplasty clinical application evaluation. Methods From Jan 2012 to Jan 2012 elderly patients with femoral head replacement 169 cases, 85 cases divided into the waist an epidural anesthesia group, 84 cases of epidural anesthesia group, observed on the respiratory and circulatory functions and anesthetic effect. Results The two groups of patients before administration, the administration of 10 min, administered 30 min, respiratory and circulatory functions surgery statistics and compare,there were no significant differences（P0.05）. The two groups were feeling, motor block onset time, block completely the time, pain recovery time and the amount of local anesthetic （P0.05）, there are significant differences. Conclusion The elderly patients because the old organ function decline in reserve capacity, decreased tolerance of anesthesia and surgery, complications, and prone to respiratory, circulatory depression, the choice of anesthetic method is more difficult.Anesthesia easy breathing management full oxygenation, but elderly patients with liver and kidney dysfunction, drug metabolism and clear slow down the emergence of drug accumulation, prone to waking delay. Spinal-epidural anesthesia （CSEA） is set to spinal anesthesia, epidural anesthesia both long, has a fast onset of anesthesia and muscle relaxants to good effect, most local anesthetics can either reach a good level of anesthesia control using a small dose of the elderly circulatory and respiratory function in patients with less impact, more secure and reliable.

关 键 词：腰-硬联合麻醉 老年股骨头置换术 临床评价 

分 类 号：R614[医药卫生—麻醉学]