全麻联合硬膜外阻滞用于老年患者全髋置换术的临床观察

Combined general anesthesia and epidural block anesthesia for elderly patients with total hip replacement

目的观察全麻联合硬膜外阻滞用于老年患者全髋置换术中血流动力学的变化与麻醉效果。方法 80例择期全髋置换术病人,按麻醉方式分为两组各40例:A组(对照组)采用单纯静吸复合全麻,B组(实验组)采用硬膜外阻滞联合静吸复合全麻。观察患者麻醉前、气管插管后、手术开始、手术1h、气管拔管时的BP、HR以及麻醉药用量,术毕自主呼吸恢复、拔管和完全清醒时间,A组采用硬膜外术后镇痛。结果 B组整个手术期间血流动力学稳定,全麻药用量B组明显少于A组(P<0.05),拔管及完全清醒时间B组较A组明显缩短(P<0.05)。结论全麻联合硬膜外阻滞用于老年全髋置换术患者血液动力学稳定,麻醉恢复期短,术后镇痛完全,具有临床应用价值。

Objective To observe the effect of combined general anesthesia and epidural block anesthesia on elderly patients with total hip replacement hemodynamic.Methods 80 patients undergoing radical surgery of total hip replacement patients were divided into two groups： A group treated with alone general anesthesia and B group treated with combined general anesthesia and epidural block anesthesia.The effects were observed.Results The hemodynamic stability during surgery and all anesthetic dosage of B group were significantly less than of A group（P〈0.05）.The time to extubation and completely sober of group B were significantly shorter than of A group（P〈0.05）.Conclusion The combined spinal and epidural block anesthesia for elderly patients with total hip replacement in patients has hemodynamic stability,short anesthesia recovery period,postoperative analgesia fully with clinical value.