高龄髋部骨折患者术中采用腰硬联合麻醉的 镇痛效果分析  

Analysis of the analgesic effect of intraoperative combined spinal epidural anesthesia in elderly patients with hip fracture

作　　者：朱祥 ZHU Xiang(Nanjing Third Hospital,Nanjing 210009,China)

机构地区：[1]南京市第三医院,210009

出　　处：《中国实用医药》2021年第33期73-75,共3页China Practical Medicine

摘　　要：目的分析高龄髋部骨折患者手术中采用腰硬联合麻醉的镇痛效果。方法70例高龄髋部骨折患者,根据随机抽取双色球法分为对照组和研究组,每组35例。对照组采取硬膜外麻醉,研究组采取腰硬联合麻醉。比较两组感觉、运动神经阻滞起效时间以及起效后持续时间,麻醉后30 min的血压、心率,术后不良反应发生情况。结果研究组感觉神经阻滞起效时间(11.35±2.62)min、运动神经阻滞起效时间(13.68±3.42)min短于对照组的(13.29±2.68)、(13.29±2.68)min,感觉神经阻滞起效后持续时间(542.51±31.69)min、运动神经阻滞起效后持续时间(524.37±30.69)min长于对照组的(525.68±30.73)、(503.68±32.35)min,差异均具有统计学意义(P<0.05)。麻醉后30 min,研究组心率(80.55±4.42)次/min、收缩压(128.26±5.17)mm Hg(1 mm Hg=0.133 kPa)、舒张压(80.73±4.12)mm Hg均低于对照组的(84.09±4.49)次/min、(131.75±5.31)mm Hg、(84.03±4.31)mm Hg,差异具有统计学意义(t=3.324、2.786、3.274,P=0.001、0.007、0.002<0.05)。研究组术后不良反应发生率为0,低于对照组的11.43%(4/35),差异具有统计学意义(χ^(2)=4.242,P=0.039<0.05)。结论在高龄髋部骨折患者手术治疗中采取腰硬联合麻醉能够快速发挥镇痛效果,且镇痛持续时间较长,对确保手术顺利进行具有重要意义,且安全性高,值得临床推广应用。Objective To analyze the analgesic effect of intraoperative combined spinal epidural anesthesia in elderly patients with hip fracture.Methods A total of 70 elderly patients with hip fractures were divided into the control group and the research group according to random two-color method,with 35 cases in each group.The control group received epidural anesthesia,and the research group received combined spinal-epidural anesthesia.Both groups were compared in terms of onset time and duration of sensory and motor nerve block,blood pressure and heart rate 30 min after anesthesia,and the occurrence of postoperative adverse reactions.Results The onset time of sensory nerve block(11.35±2.62)min and the onset time of motor nerve block(13.68±3.42)min in the research group shorter than(13.29±2.68)and(13.29±2.68)min in the control group,and the duration of sensory nerve block(542.51±31.69)min and motor nerve block(524.37±30.69)min were longer than(525.68±30.73)and(503.68±32.35)min of the control group.All the differences were statistically significant(P<0.05).30 min after anesthesia,the heart rate(80.55±4.42)beats/min,systolic blood pressure(128.26±5.17)mm Hg(1 mm Hg=0.133 kPa),and diastolic blood pressure(80.73±4.12)mm Hg in the research group were lower than(84.09±4.49)beats/min,(131.75±5.31)mm Hg,and(84.03±4.31)mm Hg in the control group,and the differences were statistically significant(t=3.324,2.786,3.274;P=0.001,0.007,0.002<0.05).The incidence of postoperative adverse reactions was 0 in the research group,which was lower than 11.43%(4/35)in the control group,and the difference was statistically significant(χ^(2)=4.242,P=0.039<0.05).Conclusion In the surgical treatment of elderly patients with hip fracture,combined spinal epidural anesthesia can quickly play the analgesic effect,and the analgesic duration is long,which is of great significance to ensure the smooth operation,and the safety of this anesthesia method is high.It is worthy of clinical promotion and application.

关 键 词：髋部骨折 高龄患者 手术治疗 腰硬联合麻醉 镇痛效果 

分 类 号：R614[医药卫生—麻醉学]