单侧腰麻轻比重大容量配方在高龄患者髋部手术中的应用  

Application of unilateral lumbar anesthesia with light ratio and large volume formula in elderly patients undergoing hip surgery

作　　者：张小琴 周磊 蔡红红 刘汗亲 黄玉 胡志成 凌建忠 刘号 ZHANG Xiaoqin;ZHOU Lei;CAI Honghong(Department of Anesthesiology,Yangzhou Hospital of TCM,Jiangsu,Yangzhou 225009,China)

机构地区：[1]江苏省扬州市中医院麻醉科,225009

出　　处：《河北医药》2023年第11期1700-1702,1706,共4页Hebei Medical Journal

摘　　要：目的研究单侧腰麻轻比重大容量配方在高龄患者髋部手术中的应用价值。方法选取2019年1月至2021年12月行髋部手术的96例高龄患者为研究对象,采用随机数字表法,按照1∶1配比原则将患者分为对照组和研究组,每组48例。髋部手术中,对照组采用全麻方法,研究组采用单侧腰麻轻比重大容量配方,比较2组麻醉情况、不同时间段的血流动力学、术后双下肢肌力恢复时间、自主排尿恢复时间以及不良反应发生率。结果对照组和研究组感觉阻滞、运动阻滞的起效时间和持续时间比较差异无统计学意义(P>0.05)。麻醉后10 min、30 min 2组平均脉动压(MVP)、心率(HR)较麻醉前降低(P<0.05),但2组比较差异无统计学意义(P>0.05);术毕2 min,2组MVP、HR比较差异无统计学意义(P>0.05)。研究组术后双下肢肌力恢复时间、自主排尿恢复时间均长于对照组(P<0.05)。结论在高龄患者髋部手术中采用单侧腰麻轻比重大容量配方,能获得与全麻相近的麻醉效果,维持血流动力学稳定,降低不良反应发生率,但患者的下肢肌力恢复较慢。Objective To study the application value of unilateral lumbar anesthesia with light ratio and large volume formula in elderly patients undergoing hip surgery.Methods A total of 96 elderly patients who underwent hip surgery in our hospital from January 2019 to December 2021 were selected as the research objects.They were randomly divided into control group and study group at the ratio of 1∶1,with 48 cases in each group.In the hip surgery,general anesthesia and unilateral lumbar anesthesia with light ratio and large volume formula were given to patients of control group and study group,respectively.The anesthesia situation,hemodynamics at different time periods,postoperative muscle strength recovery time of lower limbs,spontaneous urination recovery time and incidence of adverse reactions were compared between the two groups.Results There were no significant differences in the onset time and duration of sensory block and motor block between the two groups(P>0.05).After 10 minutes and 30 minutes of anesthesia,the mean arterial pressure(MAP)and heart rate(HR)in the two groups were significantly lower than those before anesthesia(P<0.05),but there were no significant differences in them between the two groups(P>0.05).After 2 min of operation,there were no significant differences in MVP and HR between the two groups(P>0.05).The postoperative muscle strength recovery time of lower limbs,spontaneous urination recovery time in the study group were significantly longer than those in the control group(P<0.05).Conclusion In elderly patients undergoing hip surgery,the use of unilateral lumbar anesthesia with light ratio and large volume formula can obtain an anesthetic effect similar to that of general anesthesia,which maintains hemodynamic stability and reduces the incidence of adverse events,but the recovery of lower limb muscle strength is slow.

关 键 词：高龄 髋部手术 单侧腰麻轻比重大容量配方 不良反应 

分 类 号：R614[医药卫生—麻醉学]