全麻和腰硬联合麻醉用于髋关节置换术的临床效果对比

Clinical Efficacy of Combined General Anesthesia and Lumbar Epidural Anesthesia for Hip Arthroplasty

目的对比全麻和腰硬联合麻醉用于髋关节置换术的临床效果。方法选取2016年3月—2018年1月我院收治的86例髋关节置换术患者作为研究对象。依据随机数字表法,将其分为对照组和实验组,每组各43例患者。对照组选择气管插管下全身麻醉,实验组选择腰硬联合麻醉,比较两组麻醉效果、血流动力学变化、各项麻醉指标和安全性。结果实验组麻醉优良率高于对照组,组间对比,差异具有统计学意义(P<0.05);术前,两组心率、舒张压、收缩压对比,差异均不具有统计学意义(P>0.05);术后,实验组心率、舒张压、收缩压均低于对照组,差异具有统计学意义(P<0.05);对照组用药剂量、起效时间、阻滞完全时间、清醒时间均多于实验组,组间对比,差异具有统计学意义(P<0.05);在不良反应发生率比较上,对照组高于实验组,组间对比,差异具有统计学意义(P<0.05)。结论相比于全身麻醉,髋关节置换术中运用腰硬联合麻醉,有利于维持血流动力学稳定性,减少用药量,提高麻醉效果,缩短起效时间,降低不良反应发生率。

Objective To compare the clinical effect of combined anesthesia and lumbar-sparing anesthesia for hip arthroplasty. Methods 86 cases of hip replacement in our hospital from March 2016 to January 2018 were selected as the research subjects. According to the random number table method, it was divided into the control group and the experimental group, 43 cases in each group. The control group selected general anesthesia under tracheal intubation. The experimental group selected combined spinal and epidural anesthesia. The anesthetic effect, hemodynamic changes, anesthetic indexes and safety of the two groups were compared. Results The excellent and good rate of anesthesia in the experimental group was higher than that in the control group, and the difference between the two groups was statistically significant（P 〈0.05）. Before operation, the difference of heart rate, diastolic blood pressure and systolic blood pressure between the two groups was not statistically significant（P〉 0.05）. After operation, the heart rate, diastolic blood pressure and systolic blood pressure in the experimental group were lower than those in the control group（P 〈0.05）. In the control group, the dosage, time, complete time, and waking time were more than those in the experimental group, and the difference between the groups was statistically significant（P〈 0.05）. The incidence of adverse reactions in the control group was higher than that in the experimental group, and the difference between the two groups was statistically significant（P 〈0.05）. Conclusion Compared with general anesthesia and hip arthroplasty, the use of combined spinal and epidural anesthesia is conducive to maintaining hemodynamic stability, reducing the dosage, increasing the anesthetic effect, shortening the onset time and reducing the incidence of adverse reactions.