盐酸罗哌卡因联合硬膜外麻醉在老年髋关节手术患者中的应用及对患者NIHSS评分的影响  

Application of ropivacaine hydrochloride combined with epidural anesthesia in elderly patients with hip joint surgery and the impact on patients' NIHSS scores

作　　者：王强[1] 王青华[1] 徐冰 WANG Qiang;WANG Qinghua;XU Bing(Department of Anesthesiology,Beijing Changping District Hospital,Beijing 102200,China)

机构地区：[1]北京市昌平区医院麻醉科,北京102200

出　　处：《中国现代医生》2018年第30期123-126,共4页China Modern Doctor

摘　　要：目的研究盐酸罗哌卡因联合硬膜外麻醉在老年髋关节手术患者中的具体应用以及对患者NIHSS评分的影响。方法选取2016年6月~2018年1月我院60例将要进行髋关节手术的患者,并随机分成两组,A组患者引用盐酸罗哌卡因联合硬膜外麻醉,B组患者应用硬膜外麻醉。分别观察记录两组样本麻醉前、麻醉后10、20、30 min DBP、SBP、HR的变化特点,以及两组局麻药的用药剂量、药物起效时间、药物麻醉效等。结果与麻醉前相比,麻醉后两组患者的SBP及DBP指标均明显降低(P<0.05),但降低程度均在正常范围内;经统计发现A组的时间明显短于B组(P<0.05),而A组局麻的用药量也少于B组(P<0.05),A组的阻滞完全所需时间明显短于B组(P<0.05),A组应用麻黄素的患者例数明显多于B组(P<0.05);麻醉前两组患者NIHSS比较,差异无统计学意义(P>0.05),麻醉后A组NIHSS低于B组,且组间比较,差异有统计学意义(P<0.05)。结论盐酸罗哌卡因联合硬膜外麻醉在老年髋关节手术患者中是一种比较安全有效的临床麻醉方法。Objective To investigate the specific application of ropivacaine hydrochloride combined with epidural anesthesia in elderly patients with hip joint surgery and the effect on NIHSS scores. Methods A total of 60 patients whowere going to undergo hip surgery in our hospital from June 2016 to January 2018 were randomly divided into twogroups. The A group was given ropivacaine hydrochloride combined with epidural anesthesia. And the B group wastreated with epidural anesthesia. The change characteristics of DBP, SBP and HR before anesthesia, and at 10, 20 and30 minutes after anesthesia were recorded. The doses of local anesthetics, the onset time of the drugs and the anestheticeffect of the drugs between two groups were recorded. Results Compared with those before anesthesia, the SBP andDBP indexes of the two groups were significantly lower after anesthesia（P〈0.05）, but the degree of reduction was withinthe normal range. It was found by statistics that the time of the A group was significantly shorter than that of the Bgroup（P〈0.05）, while the dose of local anesthesia in the A group was less than that of the B group（P〈0.05）. The A grouphad a significantly shorter time required for the block than the B group （P〈0.05）. The patients in A group were significantly more likely to have ephedrine than B group（P〈0.05）. There was no significant difference in NIHSS between thetwo groups before anesthesia （P〉0.05）. After anesthesia, the NIHSS in the A group was lower than that of the B group,and the difference between the two groups was statistically significant（P〈0.05）. Conclusion Ropivacaine hydrochloridecombined with epidural anesthesia is a safe and effective clinical anesthesia method in elderly patients with hip jointsurgery.

关 键 词：盐酸罗哌卡因 硬膜外麻醉 老年髋关节手术患者 NIHSS评分 

分 类 号：R614[医药卫生—麻醉学]