腰-硬联合麻醉在老年患者人工股骨头置换术中的应用

Application of combined spinal-epidural anesthesia for the eld patients in artificial femoral head replacement

目的:探讨腰-硬联合麻醉(CSEA)用于老年患者人工股骨头置换手术的临床麻醉效果及安全可行性。方法:将65岁以上的40例患者随机分为腰-硬联合麻醉组(CSEA组,20例)和硬膜外组(EA组,20例),记录麻醉起效时间、镇痛效果、阻滞平面及注药前、注药时、注药后15 min、30 min收缩压(SBP)、舒张压(DBP)、心率(HR)的变化。结果:CSEA组麻醉过程比EA组平稳,起效时间明显缩短,镇痛肌松效果确切,血流动力学影响小。结论:CSEA用于老年患者人工股骨头置换手术,只要应用得当,即可达到安全可靠、满意的麻醉效果。

Objective To explore the clinical anesthesia effect and securitied feasibility of combined spinal-epidural anesthesia for the eld patients in artificial femoral head replacement.Methods Forty cases aged exceed 65 years old were divided randomizedly into two groups：group CSEA（n=20）,received combined spinal-epidural anaesthesia;group EA（n=20）,received simple epidural anesthesia.Record the time to become effective and the analgesia effect and the blockage segment.Systolic blood pressure（SBP）,diastolic blood pressure（DBP）,heart rate（HR） were observed before administration and after administration 15 min,30 min.Results Combined spinal-epidural anesthesia group stable during anesthesia than the epidural anesthesia group,significantly shorter onset time,analgesic effects of muscle relaxation exactly,hemodynamics small.Conclusion Combined spinal and epidural anesthesia for elderly patients with femoral head replacement surgery,if properly applied,can achieve safe,reliable,satisfactory anesthesia.