全麻和腰硬联合麻醉用于髋关节置换术的麻醉效果比较

Comparison of anesthetic effects between general anesthesia and combined spinal-epidural anesthesia for hip replacement

目的探讨全身麻醉(全麻)和腰硬联合麻醉用于髋关节置换术的麻醉效果。方法 108例行髋关节置换术的患者作为研究对象,随机分为研究组与对照组,每组54例。对照组接受气管插管全麻,研究组接受腰硬联合麻醉。比较两组麻醉前、麻醉后0.5 h、麻醉后1.0 h及术后血流动力学指标(收缩压、舒张压等),麻醉药使用量,术中、术后3 d内并发症发生情况。结果两组收缩压、舒张压组内麻醉后0.5 h、麻醉后1.0 h及术后均低于本组麻醉前,差异均具有统计学意义(P<0.05)。研究组麻醉药使用量为(16.2±1.3)mg,明显少于对照组的(25.2±1.8)mg,差异具有统计学意义(t=29.786,P<0.05)。研究组并发症发生率为22.2%,明显低于对照组的50.0%,差异具有统计学意义(χ~2=9.030,P<0.05)。结论在髋关节置换术中采用腰硬联合麻醉与气管插管全麻的麻醉效果均较好,但腰硬联合麻醉麻醉药使用量更少,安全性更高。

Objective To investigate the anesthetic effects of general anesthesia and combined spinalepidural anesthesia for hip replacement.Methods A total of 108 patients with hip replacement were selected as research objects,they were randomly divided into research group and control group,54 cases in each group.The control group received general anesthesia with tracheal intubation,and the research group received combined spinal-epidural anesthesia.The hemodynamic parameters(systolic blood pressure,diastolic blood pressure and soon)before anesthesia,0.5 hour after anesthesia,1.0 hour after anesthesia and after surgery,the anesthetic dosage,intraoperative and postoperative complications within 3 days between the two groups were compared.Results The systolic blood pressure and diastolic blood pressure of the two groups at 0.5 hour after anesthesia,1.0 hour after anesthesia and after surgery were significantly lower than those before anesthesia,the differences were statistically significant(P<0.05).The anesthetic dosage of the research group was(16.2±1.3)mg,which was significantly less than(25.2±1.8)mg of the control group,the difference was statistically significant(t=29.786,P<0.05).The incidence of complications in the research group was 22.2%,which was significantly lower than 50.0%in the control group,the difference was statistically significant(χ2=9.030,P<0.05).Conclusion The anesthetic effects of combined spinal-epidural anesthesia and general anesthesia with tracheal intubation for hip replacement are all better,but the combined spinal-epidural anesthesia with less anesthetic dosage and higher safety.