腰硬联合麻醉在高龄髋关节置换术患者中的临床应用  

Clinical application of combined spinal and epidural anesthesia in elderly patients undergoing hip arthroplasty

作　　者：庞欣杰 卢锦容 李雪瑜 罗斌 黄天安[1] PANG Xinjie;LU Jinrong;LI Xueyu;LUO Bin;HUANG Tian'an(Department of Surgery and Anesthesia,Huaiji County People’s Hospital in Guangdong Province,Guangdong,Zhaoqing 526400,China)

机构地区：[1]广东省怀集县人民医院手术麻醉科,广东肇庆526400

出　　处：《中国医药科学》2022年第3期145-148,共4页China Medicine And Pharmacy

基　　金：广东省肇庆市科技计划项目(2021040308029)。

摘　　要：目的探究腰硬联合麻醉在高龄髋关节置换术患者中的应用效果。方法选取2020年10月至2021年7月于广东省怀集县人民医院手术麻醉科接受髋关节置换术治疗和手术麻醉的80例高龄患者作为研究对象,根据随机数字表法将其分为两组,每组各40例。对照组行全身麻醉,观察组行腰硬联合麻醉,比较两组患者的麻醉优良率、麻醉起效情况、麻醉药物用量、血流动力学指标波动以及不良反应发生率。结果观察组的麻醉优良率为95.00%,高于对照组的80.00%,差异有统计学意义(P<0.05);观察组的麻醉诱导用时、麻醉起效时间、完全阻滞时间短于对照组,差异有统计学意义(P<0.05);观察组的麻醉药物用量少于对照组,差异有统计学意义(P<0.05);两组麻醉前的心率和血压比较,差异无统计学意义(P>0.05),观察组麻醉后的心率和血压均大于对照组,差异有统计学意义(P<0.05);观察组的不良反应发生率为5.00%,低于对照组的22.50%,差异有统计学意义(P<0.05)。结论高龄髋关节置换术患者行腰硬联合麻醉效果较好,起效快、诱导用时低、完全阻滞时间短,且麻醉药物用量低于全身麻醉,不良反应发生率较低,值得在临床上进一步推广和应用。Objective To study the effect of combined spinal and epidural anesthesia in elderly patients undergoing hip arthroplasty.Methods A total of 80 elderly patients who underwent surgical anesthesia and hip arthroplasty in the Department of Surgery and Anesthesia of Huaiji County People’s Hospital in Guangdong Province from October 2020 to July 2021 were selected as the research objects.They were divided into two groups with 40 cases in each group according to the random number table method.The control group received general anesthesia while the observation group received combined spinal and epidural anesthesia.The rate of excellent and good anesthesia effect,the onset of anesthesia,the dosage of anesthetic drugs,the fluctuation of hemodynamic indexes and the incidence of adverse reactions were compared between the two groups.Results The rate of excellent and good anesthesia effect in the observation group(95.00%)was higher than that in the control group(80.00%),with statistically significant difference(P<0.05).The induction time,onset time and complete block time of anesthesia in the observation group were shorter than those in the control group,with statistically significant differences(P<0.05).The dosage of anesthetic drugs in the observation group was less than that in the control group,with statistically significant difference(P<0.05).There was no statistically significant difference in heart rate and blood pressure between the two groups before anesthesia(P>0.05).The heart rate and blood pressure after anesthesia in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).The incidence of adverse reactions in the observation group(5.00%)was lower than that in the control group(22.50%),with statistically significant difference(P<0.05).Conclusion Combined spinal and epidural anesthesia in elderly patients undergoing hip arthroplasty has good effect with fast onset,short induction time,short complete block time,a lower dosage of anesthetic drugs than tha

关 键 词：腰硬联合麻醉 全身麻醉 髋关节置换术 麻醉效果 

分 类 号：R614[医药卫生—麻醉学]