两种不同麻醉方法对老年全髋关节置换术患者应激反应和术后恢复的影响

Effects of two different anesthesia methods on the stress response and postoperative recovery in the elderly patients undergoing total hip replacement surgery

目的:观察喉罩全麻复合腰丛-坐骨神经阻滞在老年患者全髋关节置换术中的应用效果。方法:选择骨科单侧全髋关节置换术老年患者60例,随机分为观察组和对照组,观察组患者采用喉罩全麻复合腰丛-坐骨神经阻滞,对照组患者采用单纯喉罩全麻进行术前麻醉,对比两组患者的麻醉效果、手术应激反应、术后恢复和不良反应发生情况。结果:观察组患者达到完全神经阻滞时间明显短于对照组,且维持时间更长(P<0.05);对照组在T2至T5的白介素-6(Interleukin 6,IL-6)水平和在T1至T5的皮质醇(cortisol,COR)水平明显高于观察组(P<0.05);观察组患者术后呼吸功能恢复时间和呼唤睁眼时间更短,且术后治疗时间更短(P<0.05)。结论:喉罩全麻复合腰丛-坐骨神经阻滞应用于老年全髋关节置换术,能较好地控制好围手术期应激反应,麻醉效果佳且不影响患者的预后转归。

Objective：To observe the application effect of laryngeal mask anesthesia combined with lumbar plexus and sciatic nerve block on the elderly patients with total hip replacement surgery. Methods： 60 elderly patients with unilateral total hip replacement surgery were chosen and randomly divided into the observation group and the control group. The observation group was used Laryngeal mask anesthesia combined with lum- bar plexus and sciatic nerve block while the control group was used simple laryngeal mask anesthesia before operation, the effects of anesthesia, sur- gical stress response, postoperative recovery and adverse reactions in the two groups compared. Results： The complete block time of the observation group was significantly shorter than that of the control group and the duration of the observation group was longer than tt^at of the control group（ P 〈 0.05 ）. The levels of I1. - 6 at T2 to T5 and the COR at TI to 3＂5 in the control group were significantly higher than those in the observation group （ P 〈 0.05 ）. The respiratory function recovery time, eye opening time after calling and the postoperative treatment time in the observation ~oup are shorter than those in the control group（ P 〈 0.05 ）. Conclusion ：The laryngeal mask anesthesia combined with lumbar plexus and sciatic nerve block applied in the elderly total hip replacement surgery can control the perioperative stress response effectively with better anesthesia effect and does not affect the prognosis of patients.