摘要
目的探讨腰-硬联合麻醉在高龄患者髋关节置换术中的应用效果。方法选择包头医学院第一附属医院2009年7月至2013年1月择期接受髋关节置换术的患者135例,采用随机数字表法分为A、B、C 3组,麻醉方式分别为全身麻醉、硬膜外麻醉和腰-硬联合麻醉,各45例。观察B组和C组局部麻醉药物用量、感觉阻滞起效时间、阻滞完善时间及痛觉恢复时间;比较3组的麻醉和镇痛效果、血流动力学变化及麻醉不良反应。结果 C组的局部麻醉药物用量明显少于B组(P<0.05),感觉阻滞起效时间和阻滞完善时间均显著较B组快(P<0.01);A组和C组的麻醉效果优于B组(P<0.05),但B组和C组的术中血流动力学改变患者比例低,术后镇痛效果优于A组,术后不良反应发生率低于A组(P<0.01)。结论腰-硬联合麻醉用于高龄患者髋关节置换术中是安全、可靠的。
Objective To investigate application effect of the spinal-epidural anesthesia on hip arthro-plasty in elderly patients.Methods A total of 135 elderly patients underwent hip replacement surgery in the First Affiliated Hospital of Baotou Medical College from Jul.2009 to Jan.2013 were divided into group A,B, C according to random number table,with 45 cases in each group.Anesthesia methods for the three group were general anesthesia,epidural anesthesia and spinal-epidural anesthesia respectively.The local anesthetic dosages,onset time of sensory block,finishing time of block and recovery time of pain in group B and group C were observed;besides,the effects of anesthesia and pain blocking,hemodynamic changes and the incidence of adverse reactions of the three groups were compared.Re sults The local anesthetic dosage of group C was significantly less than group B（P〈0.05）,onset time of sensory block and finishing time of block was both significantly shorter than group B（P 〈0.01）.Anesthetic effects of group A and group C were better than group B（P〈0.05）,but the proportions of patients with changed intraoperative hemodynamic in group B and group C were lower than that in group A ,the postoperative analgesic effects of the two groups were also better than group A,and incidences of postoperative adverse reactions of the two groups were also lower than group A（P〈0.01）.Conclusion Spinal-epidural anesthesia is safe and reliable applying in the hip replacement surgery for elderly patients.
出处
《医学综述》
2015年第5期913-915,共3页
Medical Recapitulate
