腰-硬膜外联合麻醉用于老年髋关节置换手术中的实施效果分析  

Effect of Combined Spinal-epidural Anesthesia for Elderly Hip Joint Replacement Surgery

作　　者：刘毅[1] 赖敏[2] LIU Yi;LAI Min(The Municipal Hospital of Gannan Medical College,Ganzhou 341000,China)

机构地区：[1]赣南医学院附属市立医院,江西赣州341000 [2]江西省赣州市人民医院

出　　处：《中国医学创新》2018年第29期119-122,共4页Medical Innovation of China

摘　　要：目的:探讨腰-硬膜外联合麻醉用于老年髋关节置换手术中的实施效果。方法:选取2016年1月-2017年10月本院收治的老年髋关节置换手术患者70例作为研究对象,按照随机数x~表法将其分为观察组和对照组,各35例。对照组给予硬膜外麻醉,观察组给予腰-硬膜外联合麻醉,比较两组老年髋关节置换手术麻醉效果,短暂低血压、头痛并发症发生情况,麻醉前后血流动力学指标水平,以及感觉阻滞、阻滞完善和术后痛觉恢复时间。结果:两组老年髋关节置换手术麻醉效果比较,差异无统计学意义(x^2=0.000,P=1.000)。两组短暂低血压、头痛并发症发生情况比较,差异均无统计学意义(x^2=0.413 5,P=0.419 9)。麻醉前后两组MAP和HR水平比较,差异均无统计学意义(P>0.05)。观察组感觉阻滞、阻滞完善及术后痛觉恢复时间均明显短于对照组,差异均有统计学意义(P<0.05)。结论:腰-硬膜外联合麻醉用于老年髋关节置换手术中的实施效果确切,可维持术中血流动力学稳定,且不增加麻醉不良反应,但可加速起效和恢复,值得推广和应用。Objective:To investigate the effect of combined spinal-epidural anesthesia for elderly hip joint replacement surgery.Method:A total of 70 elderly patients who undergone hip joint replacement surgery from January 2016 to October 2017 were selected as the study objects.According to the random number table method,they were divided into observation group and control group,35 cases in each group.The control group was given epidural anesthesia,the observation group was given combined spinal-epidural anesthesia.The anesthesia effect of hip joint replacement surgery,the incidence of complications such as transient hypotension and headache,hemodynamic parameters before and after anesthesia,the time of sensory block,complete the block and postoperative pain recovery were compared between the two groups.Result:There was no significant difference in the anesthesia effect between the two groups of elderly hip replacement surgery(χ2=0.000,P=1.000).There were no significant differences in the incidences of transient hypotension and headache complications between the two groups(χ2=0.413 5,P=0.419 9).There were no significant differences in the levels of MAP and HR between the two groups before and after anesthesia(P>0.05).The time of sensory block,complete the block and postoperative pain recovery in the observation group were shorter than those in the control group,the differences were statistically significant(P<0.05).Conclusion:The combined spinal-epidural anesthesia has a definite effect i n the elderly hip joint replacement surgery.It can maintain the intraoperative hemodynamic stability,and does not increase anesthetic adverse reactions,but it can accelerate onset and recovery,it is worthy of promotion and application.

关 键 词：腰-硬膜外联合麻醉 老年髋关节置换手术 

分 类 号：R614[医药卫生—麻醉学]