丙泊酚静脉麻醉复合腰硬联合麻醉在髋关节骨折手术中的应用效果  

Application effect of propofol intravenous anesthesia combined with combined spinal-epidural anesthesia in hip fracture surgery

作　　者：林惠明 LIN Hui-ming(Department of Anesthesiology,Zhangzhou Second Hospital,Zhangzhou 363199,China)

机构地区：[1]福建省漳州市第二医院麻醉科,363199

出　　处：《中国现代药物应用》2024年第18期117-119,共3页Chinese Journal of Modern Drug Application

摘　　要：目的 分析在髋关节骨折手术中应用丙泊酚静脉麻醉复合腰硬联合麻醉的有效性。方法 选择72例髋关节骨折手术患者,按照掷硬币法分为观察组和对照组,每组36例。对照组施行腰硬联合麻醉,观察组施行丙泊酚静脉麻醉复合腰硬联合麻醉。对比两组术后12 h的疼痛评分、麻醉效果、血流动力学指标、认知功能情况。结果 观察组术后12 h的疼痛评分(1.92±0.21)分低于对照组的(2.46±0.23)分(P<0.05)。观察组麻醉优良率100.00%高于对照组的86.11%(P<0.05)。两组麻醉诱导前、手术结束拔管时心率及麻醉诱导前的血氧饱和度对比无明显差异(P>0.05);观察组麻醉5 min、麻醉30 min的心率分别为(69.38±5.12)、(67.27±5.23)次/min,低于对照组的(72.46±7.12)、(70.31±4.82)次/min(P<0.05);观察组麻醉5 min、麻醉30 min、手术结束拔管时血氧饱和度分别为(97.38±0.28)%、(98.32±0.28)%、(97.56±0.11)%,高于对照组的(95.77±0.25)%、(96.00±0.31)%、(95.64±0.54)%(P<0.05)。两组术前1 d简易精神状态检查量表(MMSE)评分对比无明显差异(P>0.05),观察组术后1 d、术后3 d和术后1周的MMSE评分分别为(24.11±1.33)、(26.88±1.21)、(28.31±0.98)分,高于对照组的(22.73±1.21)、(24.33±1.37)、(27.38±1.72)分(P<0.05)。结论 髋关节骨折手术中施行丙泊酚静脉麻醉复合腰硬联合麻醉的效果显著,有利于降低患者的术后疼痛感,稳定血流动力学指标,改善认知功能,值得推广。Objective To analyze the effectiveness of propofol intravenous anesthesia combined with combined spinal-epidural anesthesia in hip fracture surgery.Methods 72 patients with hip fracture surgery were divided into an observation group and a control group according to coin-tossing method,with 36 patients in each group.The control group received combined spinal-epidural anesthesia,and the observation group received propofol intravenous anesthesia combined with combined spinal-epidural anesthesia.The pain score at 12 h after surgery,anesthesia effect,hemodynamic index and cognitive function were compared between the two groups.Results 12 h after surgery,the pain score of(1.92±0.21)points in the observation group was lower than(2.46±0.23)points in the control group(P<0.05).The excellent rate of anesthesia of 100.00%in the observation group was higher than 86.11%in control group(P<0.05).There were no significant differences in heart rate before anesthesia induction and extubation at the end of surgery and blood oxygen saturation before anesthesia induction between the two groups(P>0.05).The heart rate of the observation group were(69.38±5.12)and(67.27±5.23)beats/min at 5 and 30 min of anesthesia,which were lower than(72.46±7.12)and(70.31±4.82)beats/min of the control group(P<0.05);the blood oxygen saturation of the observation group were(97.38±0.28)%,(98.32±0.28)%and(97.56±0.11)%at 5 and 30 min of anesthesia,extubation at the end of surgery,which were higher than(95.77±0.25)%,(96.00±0.31)%and(95.64±0.54)%of the control group(P<0.05).There was no significant difference in the score of the Mini-Mental State Examination(MMSE)at 1 d before surgery between the two groups(P>0.05).The MMSE scores of the observation group were(24.11±1.33),(26.88±1.21)and(28.31±0.98)points at 1 d,3 d and 1 week after surgery,which were higher than(22.73±1.21),(24.33±1.37)and(27.38±1.72)points of the control group(P<0.05).Conclusion Propofol intravenous anesthesia combined with combined spinal-epidural anesthesia is effective in

关 键 词：髋关节骨折手术 丙泊酚 静脉麻醉 腰硬联合麻醉 

分 类 号：R614[医药卫生—麻醉学]