老年人下肢骨折手术应用硬膜外麻醉、腰硬联合阻滞麻醉的效果对比

Comparison of the Effects of Epidural Anesthesia and Combined Spinal-epidural Block Anesthesia in Elderly Patients with Lower Limb Fracture Surgery

目的对比老年下肢骨折手术麻醉中选择硬膜外麻醉、腰硬联合阻滞麻醉两种方式的不同效果。方法以2018年1月—2020年4月67例老年下肢骨折患者为研究对象,按照麻醉方式分为两组,对照组接受硬膜外麻醉,观察组接受腰硬联合阻滞麻醉,比较两组麻醉效果。结果观察组麻醉药物用量少于对照组,麻醉起效时间、完全阻滞时间、麻醉后恢复时间均短于对照组,差异有统计学意义(t=8.680、9.481、10.262、7.461,P<0.05);观察组手术完成后MV、SpO2高于对照组,RR低于对照组,差异有统计学意义(P<0.05);观察组手术进行10 min、手术进行30 min镇静评分为(2.06±0.46)分、(1.71±0.29)分,均低于对照组(2.67±0.54)分、(2.03±0.31)分,差异有统计学意义(t=4.983、4.365,P<0.05)。结论老年下肢骨折手术中选择腰硬联合阻滞麻醉可较硬膜外麻醉获得更好的镇静效果,患者呼吸状况受影响更小,镇静效果更好。

Objective To compare the different effects of epidural anesthesia and combined spinal-epidural block anesthesia in the anesthesia for senile lower limb fracture surgery.Methods From January 2018 to April 2020,67 elderly patients with lower limb fractures were taken as the research objects.They were divided into 2 groups according to the method of anesthesia.The control group received epidural anesthesia,and the observation group received combined spinal-epidural anesthesia.The anesthesia effect of the two groups were compared.Results The dosage of anesthetic drugs in the observation group was less than that of the control group,and the onset time of anesthesia,complete block time,and recovery time after anesthesia were all shorter than those of the control group,the difference was statistically significant(t=8.680,9.481,10.262,7.461,P<0.05);After the operation,the MV and SpO2 were higher than the control group,and the RR was lower than the control group,the difference was statistically significant(P<0.05);the observation group was sedated at(2.06±0.46)points and(1.71±0.29)points after surgery for 10 min and 30 mins were lower than the control group(2.67±0.54)points,(2.03±0.31)points,the difference was statistically significant(t=4.983,4.365,P<0.05).Conclusion The choice of combined spinal-epidural anesthesia in the elderly lower limb fracture surgery can obtain better sedative effect than epidural anesthesia,the patient's respiratory condition is less affected,and the sedative effect is better.