全身麻醉、腰硬联合麻醉、腰丛-坐骨神经阻滞麻醉在老年下肢骨折患者切开内固定复位手术中的应用效果对比  

Comparison of the Application Effects of General Anesthesia,Combined Spinal-Epidural Anesthesia,and Lumbar Plexus-Sciatic Nerve Block Anesthesia in Open Reduction and Internal Fixation for Elderly Patients with Lower Limb Fractures

作　　者：魏向杰 曾德锋 黄颖 Wei Xiangjie;Zeng Defeng;Huang Ying(Department of Surgical Anesthesia,Heyuan Longchuan People's Hospital,Heyuan 517300,Guangdong Province,China)

机构地区：[1]河源市龙川县人民医院手术麻醉科,广东河源517300

出　　处：《中外医药研究》2025年第6期69-71,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

基　　金：河源市科技计划项目(编号:河科社077)。

摘　　要：目的:对比全身麻醉、腰硬联合麻醉、腰丛-坐骨神经阻滞麻醉在老年下肢骨折患者切开内固定复位手术中的应用效果。方法:选取河源市龙川县人民医院2021年6月—2023年12月收治的105例老年下肢骨折行切开内固定复位手术患者为研究对象。随机分为A组、B组和C组,各35例。A组给予全身麻醉,B组给予腰硬联合麻醉,C组给予腰丛-坐骨神经阻滞麻醉,各35例。比较三组麻醉效果、麻醉起效时间、术后24 h患者自控镇痛(PCA)药物用量、术后并发症发生情况。结果:B组和C组麻醉良好率高于A组(P<0.05);B组与C组麻醉良好率比较,无统计学差异(P>0.05)。B组与C组麻醉起效时间长于A组,术后24 hPCA药物用量少于A组(P<0.05);B组与C组麻醉起效时间、术后24 hPCA药物用量比较,差异无统计学意义(P>0.05)。B组和C组术后并发症发生率低于A组(P<0.05);B组与C组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论:腰硬联合麻醉、腰丛-坐骨神经阻滞麻醉在老年下肢骨折患者切开内固定复位手术中的麻醉效果及术后早期镇痛效果优于全身麻醉,且术后并发症更少。Objective:To compare the application effects of general anesthesia,combined spinal-epidural anesthesia,and lumbar plexus-sciatic nerve block anesthesia in open reduction and internal fixation for elderly patients with lower limb fractures.Methods:A total of 105 elderly patients with lower limb fractures who underwent open reduction and internal fixation at Heyuan Longchuan People's Hospital,from June 2021 to December 2023 were selected as the study subjects.They were randomly divided into Group A,group B,and Group C,with 35 cases in each group.Group A received general anesthesia,group B received combined spinal-epidural anesthesia,and Group C received lumbar plexus-sciatic nerve block anesthesia.The anesthetic effects,onset time of anesthesia,dosage of patient-controlled analgesia(PCA)at 24 hours postoperatively,and incidence of postoperative complications were compared among the three groups.Results:The rate of satisfactory anesthesia in Group B and Group C was higher than that in Group A(P<0.05).There was no significant difference in the rate of satisfactory anesthesia between Group B and Group C(P>0.05).The onset time of anesthesia in Group B and Group C was longer than that in Group A,and the dosage of PCA at 24 hours postoperatively was lower than that in Group A(P<0.05).There was no significant difference in the onset time of anesthesia and the dosage of PCA at 24 hours postoperatively between Group B and Group C(P>0.05).The incidence of postoperative complications in Group B and Group C was lower than that in Group A(P<0.05).There was no significant difference in the incidence of postoperative complications between Group B and Group C(P>0.05).Conclusion:Combined spinal-epidural anesthesia and lumbar plexus-sciatic nerve block anesthesia provide better anesthetic effects and early postoperative analgesia compared to general anesthesia in elderly patients with lower limb fractures undergoing open reduction and internal fixation,with fewer postoperative complications.

关 键 词：全身麻醉 腰硬联合麻醉 腰丛-坐骨神经阻滞麻醉 老年下肢骨折 切开内固定复位术 

分 类 号：R614[医药卫生—麻醉学]