低剂量轻比重椎管内麻醉及神经阻滞麻醉用于髋关节置换术的临床研究  

Clinical study of low-dose light specific gravity intraspinal anesthesia and nerve block anesthesia for hip replacement

作　　者：张聪 ZHANG Cong(Deparment of Anesthesiology,General Hospital of Northern Theater,Shenyang 110000,China)

机构地区：[1]北部战区总医院麻醉科,110000

出　　处：《中国实用医药》2024年第6期130-132,共3页China Practical Medicine

摘　　要：目的 评价低剂量轻比重椎管内麻醉及神经阻滞麻醉用于髋关节置换术的临床效果。方法 选取择期行骨科髋关节置换手术患者130例,采用随机数字表法分为神经阻滞麻醉组(N组)和低剂量轻比重椎管内麻醉组(C组),每组65例。N组术中行神经阻滞麻醉, C组术中行低剂量轻比重椎管内麻醉。比较两组患者麻醉效果指标和并发症发生情况、血流动力学指标。结果 C组麻醉起效时间、感觉阻滞持续时间和运动阻滞持续时间分别为(3.56±1.03)、(24.86±5.58)、(76.85±20.24)min,较N组的(16.58±2.54)、(435.29±50.68)、(298.67±50.62)min明显缩短,差异有统计学意义(P<0.05);两组并发症发生率相比无明显差异(P>0.05)。两组麻醉前、术后30 min平均动脉压(MAP)、心率(HR)水平相比无明显差异(P>0.05);N组术毕MAP、HR分别为(89.25±10.76)mm Hg(1 mm Hg=0.133 kPa)、(76.34±5.64)次/min,与C组的(93.45±11.02)mm Hg、(78.91±5.82)次/min相比明显降低,差异有统计学意义(P<0.05)。结论 髋关节置换术中行低剂量轻比重椎管内麻醉的效果比神经阻滞麻醉好,患者的血流动力学较平稳,且不会增加围术期并发症的发生,值得临床推广应用。Objective To evaluate the clinical effect of low-dose light specific gravity intraspinal anesthesia and nerve block anesthesia for hip replacement.Methods 130 patients with orthopedic hip replacement were divided into nerve block anesthesia group(group N)and low-dose light specific gravity intraspinal anesthesia group(group C)by random number table method,each with 65 cases.Group N received nerve block anesthesia during surgery,and group C received low-dose light specific gravity intraspinal anesthesia during surgery.The anesthetic effect indicators,occurrence of complications and hemodynamic indexes of the two groups were compared.Results The onset time of anesthesia,the duration of sensory block and the duration of motor block in group C were(3.56±1.03),(24.86±5.58)and(76.85±20.24)min,which were obviously shorter than(16.58±2.54),(435.29±50.68)and(298.67±50.62)min in group N,and the difference was statistically significant(P<0.05).There was no significant difference in incidence of complications between the two groups(P>0.05).There was no significant difference in mean arterial pressure(MAP)and heart rate(HR)between the two groups before anesthesia and 30 min after surgery(P>0.05).MAP and HR of group N after surgery were(89.25±10.76)mm Hg(1 mm Hg=0.133 kPa)and(76.34±5.64)beats/min,which were significantly lower than(93.45±11.02)mm Hg and(78.91±5.82)beats/min of group C.The difference was statistically significant(P<0.05).Conclusion The effect of low-dose light specific gravity intraspinal anesthesia in hip replacement is better than that of nerve block anesthesia.It can stable patients'hemodynamics and will not increase the occurrence of perioperative complications.It is worthy of clinical application.

关 键 词：髋关节置换术 低剂量轻比重椎管内麻醉 神经阻滞麻醉 麻醉效果 

分 类 号：R614[医药卫生—麻醉学]