高龄下肢骨折手术患者腰椎硬膜外联合麻醉处理及体会

Treatment and Experience of Combined Lumbar Epidural Anesthesia for Elderly Patients With Lower Limb Fracture

目的探究高龄下肢骨折手术患者腰椎硬膜外联合麻醉处理的临床疗效。方法选择2018年1月—2019年1月来院接受手术治疗的下肢骨折高龄患者作为试验研究对象,梳理分析病历资料,挑选出符合试验要求的90例患者进行入组试验,采用随机数字表法分为对照组和观察组,两组均为45例,对照组患者接受硬膜外麻醉处理,观察组患者采用腰椎硬膜外联合麻醉处理。对比分析患者阻滞起效时间、阻滞完善时间、清醒后疼痛评分及麻醉后SBP、DBP、HR和SaO_(2)的组间差异性。结果观察组患者的阻滞起效时间明显短于对照组,阻滞完善时间则明显长于对照组,组间对比差异有统计学意义(P<0.05)。观察组患者清醒后疼痛评分明显低于对照组,组间对比差异有统计学意义(P<0.05)。两组患者的SBP、DBP、HR及SaO_(2)变化组间对比差异无统计学意义(P>0.05)。结论将腰椎硬膜外联合麻醉处理应用于高龄下肢骨骨折患者的手术实践中,不仅麻醉效果显著,而且安全可靠性高。

Objective To explore the clinical effect of combined spinal epidural anesthesia in elderly patients with lower limb fracture surgery.Methods Elderly patients with lower limb fracture who came to our hospital for surgical treatment from January 2018 to January 2019 were selected as experimental subjects,the medical records were sorted out and analyzed,90 patients who met the experimental requirements were selected for the group experiment.The randomized digital table method was used to divide the patients into control group and observation group.45 cases in each group.The control group was treated with epidural anesthesia,and the observation group was treated with lumbar epidural anesthesia.The difference of onset time of block,the improvement time of block,the pain score after awake and SBP,DBP,HR and SaO_(2) after anesthesia between the two groups were compared and analyzed.Results The onset time of block in the observation group was significantly shorter than that in the control group,and the improvement time was significantly longer than that in the control group,the difference was statistically significant(P<0.05).The pain score of the observation group was significantly lower than that of the control group,and the difference between the two groups was significant,the difference was statistically significant(P<0.05).There was no significant difference in SBP,DBP,HR and SaO_(2) between the two groups(P>0.05).Conclusion The application of combined lumbar epidural anesthesia in the operation of elderly patients with lower limb bone fracture has not only significant anesthetic effect,but also high safety and reliability.