老年髋关节置换术患者中采用外周阻滞麻醉相对常规全身或椎管内麻醉效果及安全性

Comparison on effect and safety of peripheral block anesthesia and conventional general or intraspinal anesthesia in elderly patients with hip replacement

目的分析老年髋关节置换术中外周阻滞麻醉相对于常规全身或椎管内麻醉的效果及安全性。方法 60例髋关节置换术的老年患者,按麻醉方式不同分为全身组、椎管内组和外周阻滞组,各20例。全身组采用常规全身麻醉;椎管内组采用椎管内麻醉;外周阻滞组采用外周阻滞麻醉。评价并比较三组患者术后麻醉效果,记录并分析三组患者在麻醉开始时(T0)、麻醉结束时(T1)的心率(HR)、平均动脉压(MAP)。结果外周阻滞组麻醉效果优良率为90.0%,均显著高于全身组的50.0%和椎管内组的55.0%,差异均具有统计学意义(P<0.05)。三组T0时HR、MAP比较,差异无统计学意义(P>0.05);外周阻滞组T1时HR、MAP均显著低于全身组和椎管内组,差异均具有统计学意义(P<0.05)。结论在老年髋关节置换术中,外周阻滞麻醉相较于常规全身麻醉或椎管内麻醉,阻滞成功率高、效果好、安全可靠。

Objective To analyze the effect and safety of peripheral block anesthesia and conventional general or intraspinal anesthesia in elderly patients with hip replacement. Methods A total of 60 elderly patients with hip replacement were divided by different anesthesia methods into general group, intraspinal group and peripheral block group, with 20 cases in each group. The general group received conventional general anesthesia, intraspinal group received intraspinal anesthesia, and peripheral block group received peripheral block anesthesia. Postoperative anesthesia effect was evaluated and compared in three groups, and their heart rate（HR）, mean arterial pressure（MAP） were recorded and analyzed at beginning of anesthesia（T0） and end of the anesthesia（T1）. Results The peripheral block group had excellent-good rate of anesthesia as 90.0%, which was obviously higher than 50.0% in general group and 55.0% in intraspinal group, and their difference had statistical significance（P〈0.05）. Three groups had no statistically significant difference in HR and MAP at T0（P〉0.05）. The peripheral block group had obviously lower HR and MAP at T1 than general group and intraspinal group, and the difference had statistical significance（P〈0.05）. Conclusion In elderly hip replacement, peripheral block anesthesia shows higher success rate and better effect comparing with general anesthesia and intraspinal anesthesia, and it also is safe and reliable.