低浓度25G笔尖式SA针腰麻在老年人PFNA手术中的应用

Application of Low Concentration 25G Pen Type SA Needle in PFNA Oper-ation for Elderly Patients

目的探讨低浓度25 G笔尖式SA针应用于老年人PFNA手术的临床麻醉效果。方法随机选取该院于2012年9月—2013年5月间收治的60例老年人PFNA手术选用低浓度腰麻,选择L3~4穿刺为研究对象,随机分为两组,即观察组和对照组,每组各30例,其中观察组采用25G腰麻针刺入蛛网膜下腔,对照组采用普通22G斜面式穿刺针,比较两组患者在随访一个月后的麻醉消退时间、头痛、腰痛及下肢痛或感觉异常情况。结果经术后1个月随访,两组麻醉消退时间差异无统计学意义,对照组头痛5例（16.67%）、腰痛3例（10%）,下肢痛或感觉异常3例（10%）,观察组头痛2例（6.67%）,腰痛1例（3.33%）,下肢痛或感觉异常0例,观察组麻醉效果要明显优于对照组,且差异有统计学意义（P〈0.05）。结论低浓度腰麻阻滞效果完善,对循环呼吸系统影响小,术后并发症少,比较适宜老年人PFNA手术。

Objective To observe the clinical effect of low concentration 25 G pen type SA needle in the PFNA operation for elderly patients. Methods 60 cases of elderly patients with PFNA operation from the hospital in 2012 September-2013 May between selection of low concentration of spinal anesthesia puncture, choose L3-L4 as the research object, randomly divided into two groups, the observation group and the control group, 30 cases in each group, the observation group used 25 G spinal anesthesia needle into the subarachnoid space, the control group using ordinary 22 G bevel type puncture needle, compared two groups of patients in the follow-up of one month after the anesthesia regression time, headache, low back pain and leg pain or sensory abnormalities. Results After a month of follow-up after operation, two groups of anesthesia regression time difference is not obvious, no statistical significance, the control group of 5 patients with headache（16.67%）, low back pain in 3 cases（10%）, 3 cases of abnormal lower limb pain or feel（10%）, the observation group of 2 patients with headache（6.67%）, 1 cases of low back pain（3.33%）,lower limb pain or paresthesia in 0 cases, the observation group was significantly better than that of control group, the anesthesia effect, and the difference has statistical significance. Conclusion With good blockage effect, little influence on respiratory and circulatory system and less complications, low concentration spinal anesthesia is more suitable for the elderly PFNA operation.