腰-硬联合麻醉在高危老年患者骨科手术中的应用分析

Analysis of Application of Combined Spinal-epidural Anesthesia in the Orthopedic Surgery of Senile Patients with High-risk

目的探讨腰-硬联合麻醉在高危老年患者骨科手术中的应用价值。方法选取该院2014年5月—2016年3月接受骨科手术治疗的高危老年患者84例为研究对象,经随机数字表法分为观察组与对照组,每组42例,观察组行腰-硬联合麻醉,对照组行硬膜外麻醉,观察两组患者麻醉情况、镇痛效果及不良反应发生情况。结果观察组阻滞起效时间、阻滞完善时间及感觉恢复时间分别为(41.3±3.5)s、(12.2±3.1)min、(145.9±5.7)min,均明显较对照组短,观察组局麻药剂量为(7.8±1.4)mg,明显少于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率为9.52%,同对照组21.43%比较,明显较低,差异有统计学意义(P<0.05)。结论高危老年患者骨科手术应用腰-硬联合麻醉阻滞完善,镇痛效果确切,若能在术中控制好平面,处置恰当及时,不失为一种有效麻醉方法。

Objective To discuss the application value of combined spinal-epidural anesthesia in the orthopedic surgery of high-risk senile patients. Methods 84 cases of high-risk senile patients treated with operation in the orthopedic department in our hospital from May 2014 to March 2016 were selected as the research objects and randomly divided into two groups with 42 cases in each, the observation group adopted the Combined spinal-epidural anesthesia, while the control group adopted the epidural anesthesia, and the anesthesia, analgesic effect and occurrence of adverse reactions of the two groups were observed. Results The blocking onset time, blocking improvement time and feeling recovery time in the observation group were respectively（41.3±3.5）s,（ 12.2±3.1 ）rain,（ 145.9±5.7）min, which were obviously shorter than those in the control group, and the local anesthetics dosage was （7.8±1.4）mg, which was obviously less than that in the control group, and the difference had statistical significance （P〈0.05）, and the incidence rate of adverse reactions in the observation group was obviously lower than that in the control group （9.52% vs 21.43%）, and the difference had statistical significance（P〈0.05）. Conclusion The application of combined spinal-epidural anesthesia in the orthopedic surgery of high-risk senile patients is perfect, and the analgesic effect is definite, if we can control the plate I operation and carry out proper and timely treatment, it can be an effective anesthesia method.