腰丛神经阻滞在高龄患者髋关节手术中的应用

Application of Lumber Plexus Blockade for Hip Fracture Repair in Elderly Patients

目的评估腰丛神经阻滞在高龄患者髋关节手术中的应用价值。方法将87例行下肢手术的70岁以上老年患者根据不同麻醉方式分为硬膜外组(EA组)、气管插管全身麻醉组(GA组)和喉罩静脉全麻复合单侧腰从+坐骨神经阻滞组(LPB组),比较各组患者的围术期及转归情况。结果 LPB组术中芬太尼用量为(87.50±24.16)μg,明显低于GA组的(106.87±74.54)μg(P<0.05)。GA组患者术后1 d血清尿素氮水平较术前明显升高(P<0.05)。其他围术期指标改变及术后并发症发生情况3组间无明显差异。结论腰丛神经阻滞复合小剂量静脉麻醉药物可以作为高龄患者髋关节手术的麻醉选择。

Objective To evaluate the lumber plexus blockade as anesthesia technique for hip fracture repair in elderly patients.Methods We retrospectively analyzed the peri-operative data of 87 hip fracture patients,aged 70 years or older,who underwent surgical repair at our hospital between 2003 and 2006.Patients were divided into three groups according the anesthesia techniques applied: general anesthesia(GA) group(n=21),epidural anesthesia(EA) group(n=37),and lumber plexus blockade(LPB) group(n=29).Results The peri-operative data were comparable among thee three groups,except that intra-operative the dosage of fentanyl was significantly lower in LPB group compared with in GA group(P<0.05),and the blood urea nitrogen 1 day after surgery was significantly increased in GA group(P<0.05).Conclusion Lumber plexus blockade combined with small-dose intravenous anesthesia is an optional anesthetic technique for elderly patients undergoing hip fracture repair.