老年高危骨科患者腰-硬联合麻醉安全性探讨  

The Discussion About Security of Combined Spinal-epidural Anesthesia of Gerontal Patients of Orthopaedics

作　　者：杨志华 

机构地区：[1]重庆市九龙坡区第二人民医院麻醉科,400052

出　　处：《中国继续医学教育》2015年第12期30-31,共2页China Continuing Medical Education

摘　　要：目的探讨腰-硬联合麻醉在老年高危骨科患者手术中的安全性和可行性。方法选择50例ASAIII级或IV级的70岁以上全髋关节置换术和人工股骨头置换术患者作为研究对象,随机分为观察组和对照组,观察组采用腰-硬联合麻醉,对照组采用硬膜外麻醉,观察两组患者麻醉情况和并发症,并进行比较分析。结果观察组药物用量少于对照组(P<0.01)、感觉阻滞起效时间和阻滞完善时间快于对照组(P<0.05),两组患者Bromage评分等级具有显著差异(P<0.05)。结论腰-硬联合麻醉应用于老年高危骨科患者具有较高的安全性和可行性,并发症较少,是老年患者骨科手术的可靠麻醉方法。Objective Discuss the security of combined spinal-epidural anesthesia for gerontal patients of orthopaedics. Methods 50 cases of ASAIII or IV who underwent surgery as total hip replacement arthroplasty or artiifcial femoral head replacement. They were divided into observation group and control group, the observation group was administered with pinal-epidural anesthesia and the control group was administered with single epidural anesthesia. Their induction time, dose of propofol, changes of SBP, DBP, HR and RR, time of coming back to life and all the complications were observed.ResultsObservation group of local anesthetic dosage was less than control group （P〈0.01）, sensory block onset time, improve the time of arrest was significantly shorter in the control group （P〈0.05）, the Bromage of the two groups has a signiifcant difference （P〈0.05）.Conclusion It was feasibility and safety of combined spinal-epidural anesthesia for gerontal patients of orthopaedics.

关 键 词：老年患者 骨科手术 麻醉 

分 类 号：R614.3[医药卫生—麻醉学]