膝关节镜手术中局部麻醉和脊椎麻醉的临床效果比较及安全性分析  

Clinical efficacy and safety of local and spinal anesthesia in knee arthroscopic surgery

作　　者：陈华[1] 原野[1] 赵洪波[1] 王双卉 CHEN Hua;YUAN Ye;ZHAO Hong-bo;WANG Shuang-hui(Department of Anesthesiology,Second Hospital of Tangshan,Hebei Tangshan 063000,China)

机构地区：[1]唐山市第二医院麻醉科,河北唐山063000

出　　处：《中国医刊》2018年第11期1251-1253,共3页Chinese Journal of Medicine

摘　　要：目的探讨膝关节镜手术中局部麻醉和脊椎麻醉的临床效果及安全性。方法选取2015年7月至2018年1月在本院行膝关节镜手术的84例患者,采用随机数字表法随机分为局部麻醉组和脊椎麻醉组,每组42例。局部麻醉组男24例,女18例,年龄26～75岁,平均(47.6±4.6)岁,手术中均行局部麻醉;脊椎麻醉组男23例,女19例,年龄26～76岁,平均(47.2±4.2)岁,手术中均行脊椎麻醉。比较两组患者的麻醉满意度、术中及术后疼痛视觉模拟评分法(visual analogue scale,VAS)评分、术后恢复排尿的时间及并发症发生情况。结果两组患者麻醉满意度差异无显著性(P>0.05)。两组患者术中疼痛VAS评分差异无显著性(P>0.05),但是局部麻醉组术后VAS评分明显低于脊椎麻醉组,差异有显著性(P<0.05)。局部麻醉组术后恢复排尿的时间明显早于脊椎麻醉组,术后并发症发生率明显低于脊椎麻醉组,差异均有显著性(P<0.05)。结论与脊椎麻醉比较,局部麻醉可明显减轻膝关节镜手术患者的术后疼痛,缩短术后恢复排尿的时间,减少并发症的发生。Objective To investigate the clinical Efficacy and safety of local and spinal anesthesia in Knee arthroscopic surgery. Method A total of 84 patients with knee arthroscopic surgery from July 2015 to January 2018 were randomly divided into two groups, one was local anesthesia group and the other was spinal anesthesia group. There were 42 patients in each group. Result No statistical difference was found in the satisfaction degree of anesthesia between the two groups（P〉0.05）. There was no significant different about the sense of intraoperative pain between the two groups（P〉0.05）, however, the sense of postoperative pain in local anesthesia group was markedly lower when compared with spinal anesthesia group（P〈0.05）. And the recovery time of postoperative spontaneous urination was markedly shorter in local anesthesia group when compared with spinal anesthesia group（P〈0.05）. Interestingly, the cases of postoperative complications in local anesthesia group were also significantly fewer than spinal anesthesia group（P〈0.05）. Conclusion In brief, local anesthesia had a better effect in attenuating the sense of postoperative pain and the recovery time of postoperative spontaneous urination, which could also decrease the occurrence postoperative complications.

关 键 词：关节镜手术 局部麻醉 脊椎麻醉 临床疗效 安全性 

分 类 号：R684[医药卫生—骨科学] R614[医药卫生—外科学]