连续腰麻用于老年下肢骨手术50例的临床观察

Clinical Observation on Continuous Lumbar Anesthesia Applied in Aged Patients with Lower Limb Surgery

目的对比导管针法连续腰麻与腰麻-硬膜外联合阻滞麻醉用于老年下肢骨科手术的血流动力学改变、临床疗效、术后并发症,探讨连续腰麻的优越性。方法将从2008年5月至2009年2月入住东莞市常平人民医院接受治疗的50例老年下肢骨手术患者随机平均分为实验组和对照组。实验组行蛛网膜下隙穿刺,对照组行硬膜外腔穿刺。记录两组不同时刻的HR、SPO2、MAP以及麻醉效果和术后并发症等指标。结果HR、SPO2变化两组间无显著性差异(P>0.05),但术后并发症,实验组药剂用量、麻醉起效时间、辅助用药等指标显著少于对照组(P<0.05)。结论连续腰麻起效快,血流动力学维持平稳,感觉运动神经阻滞完善,安全可靠,疗效好,适合于老年患者下肢骨手术,值得在临床上应用和推广。

Objective To compare the hemodynamics changes, clinical effects and postoperative complications of ＂spinocath＂ technique（CSA） and combined spinal-epidural technique （CSEA） applied in aged patients with lower limb surgery, and investigate advantage of CSA. Methods 50 cases of aged patients with lower limb surgery in hospital for treatment from May 2008 to February 2009 were randomly divided into the experimental group and the control group on average. The experimental group were treated with CSA, and the control group were treated with CSEA.HR, SPO2, MAP and postoperative complications of two groups were recorded. Results HR and SPO2 in two groups had no significant differences（P〉0.05）, but the postoperative complications, total dosage, anesthesia effectacting period and adjuvant showed significant differences（P〈0.05）. Conclusions CSA can take effect quickly, keep hemodynamics steady, make significant and safe anesthesia effects, so it fits for aged lower limb surgery and deserves application and promotion in clinical work.