全麻复合硬膜外麻醉对老年胫腓骨骨折患者行交锁髓内钉固定术后苏醒时间的影响

Effect of general anesthesia combined with epidural anesthesia on the recovery time of elderly patients with tibia and fibula fracture after interlocking intramedullary nail fixation

目的探讨全麻复合硬膜外麻醉对老年胫腓骨骨折患者行交锁髓内钉固定术后苏醒时间的影响。方法选取本院2015年11月—2017年9月胫腓骨骨折老年患者76例,随机数字表法分为对照组(n=38)与研究组(n=38)。对照组采取全身麻醉,研究组在对照组基础上采取硬膜外麻醉。统计两组麻醉及术后恢复情况(麻醉起效时间、术后清醒时间)、术后1、3、6h时疼痛程度(VAS)分值、不良反应发生率。结果研究组麻醉起效时间、术后清醒时间短于对照组(P<0.05);术后1、3、6h研究组VAS分值低于对照组(P<0.05);研究组不良反应发生率10.53%(4/38)低于对照组28.95%(11/38)(P<0.05)。结论老年胫腓骨骨折患者交锁髓内钉固定术治疗中,采取全麻复合硬膜外麻醉可缩短麻醉起效及术后清醒时间,减轻术后疼痛感,且可降低不良反应发生风险,具有安全性。

Objective To investigate the effect of general anesthesia combined with epidural anesthesia on the recovery time of elderly patients with tibia and fibula fracture after interlocking intramedullary nail fixation.Methods A total of 76 cases of tibia and fibula fracture in our hospital from Nov.2015 to Sep.2017 were selected and divided into the control group(n=38)and the study group(n=38).The control group was given general anesthesia,and the study group was given epidural anesthesia on the basis of the control group.The anesthesia and postoperative recovery(anesthesia onset time,postoperative recovery time)conditions,the pain degree(VAS)score at 1 h,3 h and 6h after operation,and the incidence of adverse reactions of two groups were statistically recorded.Results The time of the onset of anesthesia of the study group and the time of postoperative sobriety were shorter than those of the control group(P<0.05).The VAS score at 1 h,3 h and 6 h after operation of the study group was lower than that of the control group(P<0.05).The incidence of adverse reactions of the study group 10.53%(4/38)was lower than that of the control group 28.95%(11/38).Conclusion In elderly patients with tibiofibula fracture treated by interlocking intramedullary nail fixation,general anesthesia combined with epidural anesthesia can shorten the anesthesia onset time and postoperative recovery time,relieve postoperative pain and reduce the risk of adverse reactions.Besides,it is safe.