老年髋关节手术患者实施小剂量舒芬太尼联合罗哌卡因蛛网膜下腔阻滞的麻醉效果  

Effect analysis of low dose sufentanil combined with ropivacaine subarachnoid block in elderly patients undergoing hip joint operation

作　　者：桂琳 朱洪宽 GUI Lin;ZHU Hongkuan(Department of Anesthesiology,The First People's Hospital of Qujing City,Qujing,Yu'nan,655000,China)

机构地区：[1]曲靖市第一人民医院麻醉科,云南曲靖655000

出　　处：《当代医学》2024年第1期74-78,共5页Contemporary Medicine

摘　　要：目的探讨老年髋关节手术患者实施小剂量舒芬太尼联合罗哌卡因蛛网膜下腔阻滞的麻醉效果。方法选取2021年1—12月曲靖市第一人民医院收治的80例择期行老年髋关节置换手术患者作为研究对象,按照随机数字表法分为观察组与对照组,每组40例。对照组采用罗哌卡因进行蛛网膜下腔阻滞,观察组采用小剂量舒芬太尼联合罗哌卡因进行蛛网膜下腔阻滞。比较两组麻醉效果、疼痛程度、镇静评分、认知功能、生命体征及不良反应发生情况。结果观察组感觉阻滞起效时间、运动阻滞起效时间短于对照组,平面阻滞消退时间、运动阻滞恢复时间均长于对照组(P<0.05);术后4h,观察组视觉模拟评分法(VAS)评分、Ramsay镇静评分均低于对照组(P<0.05)。麻醉后5min,观察组收缩压、舒张压高于对照组,心率低于对照组(P<0.05);麻醉后30min,两组收缩压、舒张压、心率、呼吸频率比较差异无统计学意义。麻醉后4h,两组定向力、言语能力、注意力和计算力、瞬时记忆、视空间评分均低于麻醉前,但观察组定向力、言语能力、注意力和计算力、瞬时记忆、短时记忆、视空间评分均高于对照组(P<0.05)。观察组不良反应发生率低于对照组(P<0.05)。结论小剂量舒芬太尼联合罗哌卡因蛛网膜下腔阻滞对老年髋关节手术患者的麻醉效果理想,有利于增加麻醉血药浓度,减轻术后疼痛程度,改善镇静效果及认知功能,且安全性较高,值得临床推广应用。Objective To investigate the effect of low dose sufentanil combined with ropivacaine subarachnoid block in elderly patients undergo-ing hip joint operation.Methods A total of 80 elderly patients undergoing hip joint operation in the First People's Hospital of Qujing from January to December 2021 were selected as the study subjects,and they were divided into the observation group and the control group according to the random number table method,with 40 cases in each group.The control group received subarachnoid block with ropivacaine,and the observation group re-ceived subarachnoid block with low dose sufentanil combined with ropivacaine.The anesthesia effect,pain degree,sedation score,cognitive function,vital signs and adverse reactions were compared between the two groups.Results The onset time of sensory block and motor block in the observation group were shorter than those in the control group,and the regression time of plane block and recovery time of motor block were longer than those in the control group(P<0.05).4 h after operation,the visual analogue scale(VAS)score and Ramsay sedation score in the observation group was lower than those in the control group(P<0.05).5 min after anesthesia,the systolic and diastolic blood pressure in the observation group were higher than the control group,and the heart rate was lower than that in the control group(P<0.05);30 min after anesthesia,there were no significant differences in sys-tolic,diastolic blood pressure,heart rate and respiratory rate between the two groups.4 h after anesthesia,the orientation force,speech ability,attention and calculation power,instantaneous memory and visual space score of the two groups were lower than those before anesthesia,but the orientation force,speech ability,attention and calculation power,instantaneous memory,memory of short memory and visual space score in the observation group were higher than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group

关 键 词：老年髋关节手术 小剂量 舒芬太尼 罗哌卡因 蛛网膜下腔阻滞 麻醉效果 

分 类 号：R614[医药卫生—麻醉学]