罗哌卡因复合舒芬太尼蛛网膜下腔麻醉在高龄髋关节手术患者中的麻醉效果分析

Analysis of the Effect of Ropivacaine Combined with Sufentanil Subarachnoid Anesthesia in Elderly Patients Undergoing Hip Surgery

目的:探讨罗哌卡因复合舒芬太尼蛛网膜下腔麻醉在高龄髋关节手术患者中的麻醉效果。方法:选取2018年6月-2020年7月厦门市第三医院收治的74例行髋关节手术的高龄患者,根据数字表法将患者分为参照组和研究组,每组37例。参照组采用单纯罗哌卡因麻醉,研究组采用罗哌卡因复合舒芬太尼麻醉。比较两组感觉阻滞时间、感觉恢复时间、运动恢复时间;比较两组运动阻滞评分、术中疼痛评分、术后疼痛评分、麻醉肌松评分;比较两组麻醉后10 min、术后1 h的生命体征;比较两组不良反应发生情况。结果:研究组感觉阻滞时间早于参照组,差异有统计学意义(P<0.05)。两组感觉恢复时间和运动恢复时间比较,差异均无统计学意义(P>0.05)。两组运动阻滞评分、麻醉肌松评分比较,差异均无统计学意义(P>0.05);研究组术中疼痛评分、术后疼痛评分均低于参照组,差异均有统计学意义(P<0.05)。麻醉后10 min、术后1 h,两组舒张压、收缩压、心率比较,差异均无统计学意义(P>0.05)。研究组不良反应发生率低于参照组,但差异无统计学意义(P>0.05)。结论:在高龄髋关节手术中采用罗哌卡因复合舒芬太尼蛛网膜下腔麻醉可缩短感觉阻滞时间,术中术后止痛效果强,安全性较高。

Objective:To explore the anesthesia effect of Ropivacaine combined with Sufentanil subarachnoid anesthesia in elderly patients undergoing hip surgery.Method:A total of 74 elderly patients undergoing hip surgery admitted to the Third Hospital of Xiamen City from June 2018 to July 2020 were selected,they were divided into reference group and study group according to the number table method,37 cases in each group.The reference group was treated with pure Ropivacaine anesthesia,the study group was treated with Ropivacaine combined with Sufentanil anesthesia.The sensory block time,sensory recovery time and motor recovery time were compared between two groups;the motor block score,intraoperative pain score,postoperative pain score and anesthesia muscle relaxation score were compared between two groups;the vital signs of both groups were compared 10 min after anesthesia and 1 h after surgery;the incidence of adverse reactions was compared between two groups.Result:The sensory block time in the study group was earlier than that in the reference group,the difference was statistically significant(P<0.05).There were no significant differences in sensory recovery time and motor recovery time between two groups(P>0.05).There were no significant differences in motor block score and anesthesia muscle relaxation score between two groups(P>0.05).The intraoperative and postoperative pain scores in the study group were lower than those in the reference group,the differences were statistically significant(P<0.05).There were no significant differences in diastolic blood pressure,systolic blood pressure and heart rate between two groups at 10 min after anesthesia and 1 h after surgery(P>0.05).The incidence of adverse reaction in the study group was lower than that in the reference group,the difference was not statistically significant(P>0.05).Conclusion:The use of Ropivacaine combined with Sufentanil subarachnoid anesthesia in hip surgery for the elderly can shorten the sensory block time,have a strong intraoperative and postoperative analgesic effect and high safety.