腰-硬联合麻醉用于高龄下肢手术患者的临床观察

Clinical observation of combined spinal epidural anesthesia for lower limb surgery in elderly patients

目的:探讨腰-硬联合麻醉(CSEA)在80岁以上高龄患者下肢手术中应用的有效性及安全性。方法:选取下肢手术高龄患者56例,随机分为观察组和对照组。观察组31例患者采用腰-硬联合麻醉;对照组25例患者给予全麻。结果:两组患者术中及术后血氧饱和度(Sp O2)比较无明显差异(P>0.05);两组患者注药后5 min时MAP均下降,且对照组下降更明显(P<0.05);注药后5 min两组患者的HR值均增快,对照组患者增快幅度高于观察组,两组比较差异有统计学意义(P<0.05)。结论:在高龄患者下肢手术中应用腰-硬联合麻醉,效果良好,安全可行。

Objective： To investigate validity and safety of combined spinal epidural anesthesia in lower limb surgery among patients over the age of 80 years. Methods： 56 elderly patients underwent lower limb surgery were randomly divided into two groups：observation group and control group. In the observation group, 31 cases were anesthetized via the combined spinal epidural approach;while in the control group, 25 cases were given general anesthesia. Results： There was no significant difference in the intraoperative and postoperative SpO2 between the two groups （P〉0. 05）; MAP in the two groups began to decrease 5 minutes after injection, and the decline was more apparent in control group （P〈0. 05）. HR values were faster 5 minutes after injection in the two groups, and the increase in control group was significantly higher than that in observation group; the differences between the two groups were statistical-ly significant （P〈0. 05）. Conclusions： The combined spinal epidural anesthesia is a safe and feasible method for lower limb surgery among the elderly patients.