脊椎麻醉联合硬膜外麻醉对老年下肢骨折患者的应用效果分析  

Analysis of Application Effect of Spinal Anesthesia Combined with Epidural Anesthesia in Elderly Patients with Lower Extremity Fractures

作　　者：杜鸣 喻平[1] 叶波林 陈欢[1] 王耀辉 Du Ming;Yu Ping;Ye Bo-lin;Chen Huan;Wang Yao-hui(Department of Anesthesiology,Dongguan Huangjiang Hospital,Dongguan 523507,Guangdong Province,China)

机构地区：[1]东莞市黄江医院麻醉科,广东东莞523507

出　　处：《中国社区医师》2023年第12期38-40,共3页Chinese Community Doctors

摘　　要：目的:探究老年下肢骨折手术患者实施脊椎麻醉联合硬膜外麻醉的临床应用价值。方法:选取2020年6月—2021年12月东莞市黄江医院收治的68例老年下肢骨折患者作为研究对象,根据麻醉方式不同分为观察组和对照组,各34例。对照组实施连续硬膜外麻醉,观察组实施脊椎麻醉联合硬膜外麻醉。对比两组麻醉效果、监测指标及麻醉不良反应发生情况。结果:两组麻醉维持时间比较,差异无统计学意义(P=0.725 2);观察组麻醉药物用量少于对照组,麻醉起效时间、阻滞完善时间短于对照组,差异有统计学意义(P=0.000 0)。麻醉前,两组心率(HR)、血氧饱和度(SpO_(2))、收缩压(SBP)、舒张压(DBP)水平比较,差异无统计学意义(P>0.05);麻醉5 min、麻醉10 min、麻醉20 min,观察组HR、SpO_(2)、SBP、DBP水平均低于对照组,差异有统计学意义(P=0.000 0)。观察组麻醉不良反应总发生率低于对照组,差异有统计学意义(P=0.039 9)。结论:老年下肢骨折患者实施脊椎麻醉联合硬膜外麻醉,可获得理想的麻醉效果,具有起效时间短、麻醉不良反应少、麻醉药物用量少、生命体征波动幅度小等优势。Objective:To explore the clinical application value of spinal anesthesia combined with epidural anesthesia in elderly patients with lower extremity fracture surgery.Methods:Sixty-eight elderly patients with lower extremity fractures admitted to Dongguan Huangjiang Hospital from June 2020 to December 2021 were selected as the study subjects.According to different anesthesia methods,they were divided into an observation group and a control group,with 34 cases in each group.The control group was given continuous epidural anesthesia and the observation group was given spinal anesthesia combined with epidural anesthesia.The anesthesia effect,monitoring indicators and the occurrence of adverse reactions of anesthesia were compared between the two groups.Results:There was no significant difference in the maintenance time of anesthesia between the two groups(P=0.7252).The amount of anesthetic drugs used in the observation group was less than that in the control group,and the anesthesia onset time and block perfection time in the observation group were shorter than those in the control group,and the difference was statistically significant(P=0.0000).Before anesthesia,there was no significant difference in the heart rate(HR),blood oxygen saturation(SpO_(2)),systolic blood pressure(SBP),and diastolic blood pressure(DBP)levels between the two groups(P>0.05).The levels of HR,SpO_(2),SBP and DBP in the observation group were lower than those in the control group at 5 min,10 min and 20 min after anesthesia,and the difference was statistically significant(P=0.0000).The total incidence of adverse anesthesia reactions in the observation group was lower than that in the control group,and the difference was statistically significant(P=0.0399).Conclusion:Spinal anesthesia combined with epidural anesthesia for elderly patients with lower extremity fractures can achieve an ideal anesthesia effect.It has the advantages of short onset time,few adverse reactions of anesthesia,less dosage of anesthetic drugs,and small fluctuations in vital

关 键 词：下肢骨折 老年 硬膜外麻醉 脊椎麻醉 监测指标 

分 类 号：R614[医药卫生—麻醉学]