摘要
目的探讨布比卡因椎管内麻醉在老年骨科手术患者中的应用效果及对精神认知、麻醉恢复、并发症发生情况的影响。方法选择我院2018年6月至2021年6月收治的98例老年骨科手术患者为研究对象,随机将其分为对照组和研究组,各49例。对照组接受舒芬太尼复合丙泊酚全身麻醉,研究组接受布比卡因椎管内麻醉。比较两组的手术及麻醉相关指标、精神认知功能、P3潜伏期与波幅变化、术中及术后并发症发生情况。结果研究组的手术时间、麻醉起效时间、麻醉苏醒时间、自主呼吸恢复时间及麻醉室留观时间均短于对照组,差异具有统计学意义(P<0.05)。术前、术后12 h,两组的简明精神状态量表(MMSE)、数字广度测验(DST)及数字符合转换测验(DSST)量表评分比较,差异无统计学意义(P>0.05);术后6 h,研究组的MMSE、DST、DSST评分均显著高于对照组,差异具有统计学意义(P<0.05)。术前及术后12 h,两组的P3潜伏期与波幅比较,差异无统计学意义(P>0.05);术后1、6 h,研究组的P3潜伏期短于对照组,P3波幅大于对照组,差异具有统计学意义(P<0.05)。研究组的术中及术后并发症总发生率低于对照组,差异具有统计学意义(P<0.05)。结论布比卡因椎管内麻醉可有效缩短手术及术后麻醉恢复时间,减少麻药用量,且对患者精神认知功能影响小,术中及术后并发症发生率低,在老年骨科手术患者麻醉中较全身麻醉更具优势,值得临床推广与应用。
Objective To explore the application effect of bupivacaine intraspinal anesthesia in elderly patients undergoing orthopedic surgery and its influences on mental cognition,anesthesia recovery and complications.Methods A total of 98 elderly patients undergoing orthopedic surgery admitted in our hospital from June 2018 to June 2021 were selected as the research objects and randomly divided into control group and study group,with 49 cases in each group.The control group received sufentanil combined with propofol general anesthesia,and the study group received bupivacaine intraspinal anesthesia.The operation and anesthesia related indexes,mental cognitive function,P3 latency and amplitude changes,intraoperative and postoperative complications were compared between the two groups.Results The operation time,anesthesia onset time,anesthesia recovery time,spontaneous breathing recovery time and anesthesia room observation time of the study group were shorter than those of the control group,and the differences were statistically significant(P<0.05).There were no significant differences in the scores of Minimental State Examination(MMSE),Digit Span Test(DST)and Digit Symbol Substitution Test(DSST)between the two groups before and 12 h after operation(P>0.05);at 6 h after operation,the MMSE,DST and DSST scores of the study group were significantly higher than those of the control group,and the differences were statistically significant(P<0.05).There were no significant differences in P3 latency and amplitude between the two groups before and 12 h after operation(P>0.05);at 1 and 6 h after operation,the P3 latency of the study group was shorter than that of the control group,the P3 amplitude was larger than that of the control group,and the differences were statistically significant(P<0.05).The total incidence of intraoperative and postoperative complications in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Bupivacaine intraspinal anesthesia can ef
作者
黄太林
黄朝胜
HUANG Tailin;HUANG Chaosheng(Anesthesiology Department,Ankang People's Hospital,Ankang 725000,China)
出处
《临床医学研究与实践》
2023年第11期80-83,共4页
Clinical Research and Practice
关键词
全身麻醉
布比卡因
椎管内麻醉
骨科手术
精神认知功能
麻醉恢复
general anesthesia
bupivacaine
intraspinal anesthesia
orthopaedic surgery
mental cognitive function
anesthesia recovery
