腰-硬联合麻醉在老年下肢手术中的应用效果分析

Combined spinal epidural anaesthesia in the elderly lower limb surgery effectiveness analysis

目的观察腰-硬联合麻醉在老年下肢手术中的应用效果。方法将我院140例拟行下肢手术的老年患者随机分为观察组及对照组,观察组采用腰麻-硬膜外联合麻醉,对照组采用硬膜外麻醉。结果两组麻醉效果优良率差异无统计学意义(P>0.05),但观察组麻醉起效时间、运动阻滞起效时间、麻醉药用量、阻滞完全比例明显少于对照组(P<0.05)。两组患者注药前及注药后心率、血压、血氧饱和度无明显变化,均无恶心、呕吐、头痛等不良反应。结论腰-硬联合麻醉应用于老年下肢手术能充分发挥腰麻与硬膜外麻醉的双重优点,阻滞效果完善,可控性好,肌松充分,作用发挥快而完全,用药量小,对患者生理功能干扰小,对老年人下肢手术尤其适用,是一种效果确切,安全可靠的麻醉方法。

Objective Observe combined spinal epidural anaesthesia in the elderly lower limb surgery results. Methods140 cases of elderly patients who underwent lower extremity surgery were randomly divided into control group and observe group in our hospital, to observe the group with spinal anesthesia - epidural anesthesia, epidural anesthesia control group. Observation group patients were treated with combined spinal epidural anaesthesia, control group patients were treated with combined epidural anesthesia. Results Both groups anesthesia excellent rates was no significant difference （P 〉 0. 05 ） , but the observation group, the onset time of anesthesia, motor block onset time, anesthetic dosage, complete block was significantly less than the control group （P 〈 0. 05） . Two groups of patients before and after injection, heart rate, blood pressure, oxygen saturation no significant changes, no nausea, vomiting, headaches and other adverse reactions. Conclusion Combined spinal epidural anaesthesia can give full play to the dual advantages of epidural anesthesia, block the effect sound, good controllability, full muscle relaxation, play the role offast and completely, the dosage is small, the interference of physiological function in patients with small, especially for the elderly lower extremity surgery, is an effect, safe and reliable method of anesthesia.