高龄患者髋部骨科手术腰硬联合麻醉的安全性及临床应用  

The Safety and Clinical Application of Combined Lumbar Epidural Anesthesia in Hip Orthopedic Surgery for Elderly Patients

作　　者：王诗琼 WANG Shiqiong(Wan’an county hospital of TCM,Wan’an,Jiangxi 343800)

机构地区：[1]万安县中医院,江西万安343800

出　　处：《中国伤残医学》2024年第7期37-40,共4页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探究硬膜外麻醉与腰硬联合麻醉在高龄患者髋部骨科手术的应用效果及安全性。方法:选取2022年1月-2023年2月我院收治的80例髋部骨科手术患者为研究对象,随机分成对照组和观察组,各40例。对照组采用硬膜外麻醉,观察组采用腰硬联合麻醉。对2组的麻醉效果、麻醉安全性等指标进行对比。结果:观察组患者在麻醉后不同时间点的疼痛评分及并发症发生率比对照组低,组间差异有统计学意义(P<0.05);观察组在T1~3时间段的平均动脉压和心率均比对照组低,组间差异有统计学意义(P<0.05)。观察组麻醉优良率比对照组高,差异有统计学意义(P<0.05)。观察组阻局部麻醉用量比对照组少,阻滞完善时间和感觉阻滞起效时间比对照组短,下肢Bromage评分比对照组高,组间差异有统计学意义(P<0.05)。结论:腰硬联合麻醉在高龄患者髋部骨科手术中的应用具有重要意义,其麻醉效果和镇痛效果明显,在降低麻醉药物使用剂量的同时,还能稳定血流动力学指标,可降低术后并发症发生率,其应用具有一定的安全性。Objective:To explore the application effect and safety of epidural anesthesia and combined lumbar epidural anesthesia in hip orthopedic surgery in elderly patients.Methods:80 patients with hip orthopedic surgery admitted to our hospital from January 2022 to February 2023 were selected as the research subjects,randomly divided into a control group and an observation group,with 40 cases in each group.The control group received epidural anesthesia,while the observation group received combined lumbar epidural anesthesia.The anesthesia effects,anesthesia safety,and other indicators between two groups were compared.Results:The observation group had lower pain scores and incidence of complications at different time points after anesthesia compared to the control group the differences were statistically significant between the groups(P<0.05).The average arterial pressure and heart rate of the observation group were lower than those of the control group during T1~3 periods,the differences were statistically significant between the groups(P<0.05).The observation group had a higher rate of excellent anesthesia compared to the control group,the difference was statistically significant(P<0.05).The observation group had a lower dosage of local anesthesia compared to the control group,a shorter duration of block completion and sensory block onset,and a higher lower limb Bromage score compared to the control the differences were statistically significant between the groups group(P<0.05).Conclusion:The application of combined lumbar and epidural anesthesia in hip orthopedic surgery in elderly patients is of great significance.Its anesthetic and analgesic effects are significant.While reducing the dosage of anesthetic drugs,it can also stabilize the patient’s hemodynamic indicators and reduce the incidence of postoperative complications.Its application has high safety.

关 键 词：髋部骨科手术 高龄患者 硬膜外麻醉 腰硬联合麻醉 安全性 应用效果 

分 类 号：R614[医药卫生—麻醉学]