摘要
目的探讨小剂量罗哌卡因复合芬太尼用于老年人下肢骨折手术麻醉的应用效果。方法选择山西省太原钢铁(集团)有限公司总医院迎新街院区2016年1月至2017年5月接受手术治疗的老年下肢骨折患者300例为研究对象,采用随机数字表法分为对照组、观察组各150例,对照组采取常规剂量罗哌卡因复合芬太尼麻醉,观察组采取小剂量罗哌卡因复合芬太尼麻醉,比较两组的麻醉效果、麻醉阻滞情况、术中生命体征变化情况、术中低血压发生率、术后并发症发生率。结果两组麻醉优良率均为100.0%,差异无统计学意义(P>0.05);对照组阻滞起效时间、阻滞消退时间、运动神经阻滞评分分别为(6.35±1.87)min、(73.25±17.89)min、(2.69±0.30)分,观察组分别为(6.42±1.61)min、(74.56±19.24)min、(2.63±0.32)分,两组差异均无统计学意义(均P>0.05);两组术中血压、心率、体温均较麻醉前有轻微下降,但差异均无统计学意义(均P>0.05);观察组术中低血压发生率为2.7%,明显低于对照组的8.7%(χ^2=5.051,P<0.05);观察组术后并发症发生率为3.3%,对照组为5.3%,两组差异无统计学意义(P>0.05)。结论 在老年下肢骨折患者手术中,采用小剂量罗哌卡因复合芬太尼的麻醉效果显著,与常规剂量罗哌卡因复合芬太尼的麻醉效果相当,可维持患者术中生命体征平稳,还可减少术中低血压发生,可作为老年人下肢骨折手术中的理想麻醉方法。
Objective To investigate the effect of small dose of ropivacaine combined with fentanyl on anesthesia in elderly patients with lower limb fracture.Methods A total of 300 elderly patients with lower limb fractures in Yingxin Street Branch of Shanxi Taisteel General Hospital were selected in the research.The patients were randomly divided into control group and observation group according to the digital table,with 150 cases in each group.The control group received routine dose of ropivacaine combined with fentanyl anesthesia,the observation group was given small doses of ropivacaine combined with fentanyl anesthesia.The anesthesia effect,anesthesia block,changes of vital signs during the surgery,the incidence of intraoperative hypotension,and incidence rate of complications were compared between the two groups.Results The excellent rate of anesthesia in the two groups was 100.0%,the difference was not statistically significant(P>0.05). The block onset time,block fading time,motor block score in the control group were (6.35±1.87)min,(73.25±17.89)min,(2.69±0.30)points,respectively,which in the observation group were (6.42±1.61)min,(74.56±19.24)min,(2.63±0.32)points,respectively,the differences between the two groups were not statistically significant(all P>0.05). During operation,the blood pressure,heart rate,body temperature in the two groups were decreased slightly compared with before anesthesia,but the differences were not statistically significant(all P>0.05). The incidence rate of intraoperative hypotension of the observation group was 2.7%,which was significantly lower than 8.7% of the control group (χ^2=5.051,P<0.05). The incidence rate of complications in the observation group was 3.3%,which in the control group was 5.3%,there was no statistically significant difference between the two groups(P>0.05).Conclusion For elderly patients with lower extremity fractures,small dose of ropivacaine combined with fentanyl has obvious anesthesia effect,the anesthetic effect is similar with routine dose of ropivaca
作者
张渤
Zhang Bo(Department of Anesthesiology,Yingxin Street Branch of Shanxi Taisteel General Hospital,Taiyuan,Shanxi 030008, China)
出处
《中国基层医药》
CAS
2018年第23期3024-3027,共4页
Chinese Journal of Primary Medicine and Pharmacy
关键词
骨折
麻醉
罗哌卡因
芬太尼
老年人
Fractures,bone
Anesthesia
Ropivacaine
Fentanyl
Aged
