微量泵持续给药与间断分次给药硬膜外麻醉在高龄股骨粗隆间骨折患者内固定手术中的应用效果比较  

Comparison of effects of micropump continuous and intermittent administration epidural anesthesia in internal fixation of elderly patients with femoral intertrochanteric fractures

作　　者：王梦 WANG Meng(Department of Anesthesiology of Pingdingshan People’s Hospital No.1,Pingdingshan 467000 Henan,China)

机构地区：[1]平顶山市第一人民医院麻醉科,河南平顶山467000

出　　处：《中国民康医学》2022年第1期135-137,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:比较微量泵持续给药与间断分次给药硬膜外麻醉在高龄股骨粗隆间骨折(ITF)患者股骨近端防旋髓内钉(PFNA)内固定手术中的应用效果。方法:回顾性分析2017年5月至2020年8月该院收治的102例高龄ITF患者的临床资料,根据麻醉给药方式不同分为对照组(n=51)和研究组(n=51)。对照组采用分次给药硬膜外麻醉,研究组采用微量泵持续给药硬膜外麻醉,比较两组围术期[麻醉前(T_(0))、麻醉起效后(T_(1))、切皮时(T_(2))、切皮后10 min(T_(3))、切皮后30 min(T_(4))、术毕即刻(T_(5))]血流动力学指标变化情况、麻醉效果、不良反应发生率及罗哌卡因总用量。结果:T_(2)时两组心率(HR)、平均动脉压(MAP)均明显升高,T_(3)时两组HP、MAP均明显降低,但研究组变化幅度较小,且研究组T_(2)、T_(3)、T_(4)、T_(5)时的HR、MAP均低于对照组,差异有统计学意义(P<0.05);研究组麻醉优良率为98.04%(50/51)高于对照组的84.31%(43/51),差异有统计学意义(P<0.05);研究组罗哌卡因总用量少于对照组,不良反应发生率低于对照组,差异均有统计学意义(P<0.05)。结论:微量泵持续给药硬膜外麻醉用于高龄ITF患者PFNA术中,能维持血流动力学稳定,提高麻醉效果,且能减少麻醉药物用量,降低不良反应发生率,效果优于间断分次给药。Objective:To compare effects of micropump continuous and intermittent divided administration epidural anesthesia in proximal femoral nail anti-rotation internal fixation in elderly patients with intertrochanteric fractures(ITF).Methods:A retrospective analysis of the clinical data of 102 elderly patients with ITF admitted to the hospital from May 2017 to August 2020 was performed.According to the different methods of anesthesia administration,they were divided into control group(n=51)and study group(n=51).The control group was given divided dose epidural anesthesia,while the study group was given micropump continuous administration epidural anesthesia.The changes of the hemodynamic indicators during the perioperative period[before anesthesia(T_(0)),after the onset of anesthesia(T_(1)),at skin incision(T_(2)),10 minutes after the skin incision(T_(3)),30 minutes after the skin incision(T_(4)),immediately after the surgery(T_(5))],the anesthesia effects,the incidence of adverse reaction,and total dosage of Ropivacaine were compared between the two groups.Results:At T_(2),the heart rate(HR)and mean arterial pressure(MAP)of the two groups increased significantly.At T_(3),the HP and MAP in the two groups were significantly reduced,but the changes in the study group were smaller.The HR and MAP of the study group at T_(2),T_(3),T_(4),and T_(5) were lower than those of the control group.All the above differences were statistically significant(P<0.05).The excellent and good rate of anesthesia in the study group was 98.04%(50/51),which was higher than the control group of 84.31%(43/51),and the difference was statistically significant(P<0.05).The total dosage of Ropivacaine in the study group was less than that in the control group;the incidence of adverse reactions was lower than that in the control group;and the differences were statistically significant(P<0.05).Conclusions:Micropump continuous administration epidural anesthesia in PFNA of the elderly patients with ITF can maintain the hemodynamic stability,improve the ane

关 键 词：股骨粗隆间骨折 高龄 硬膜外麻醉 微量泵持续给药 血流动力学 

分 类 号：R614[医药卫生—麻醉学]