老年下肢骨折患者手术中腰麻-硬膜外联合麻醉的应用价值分析

Analysis on application values of spinal anesthesia combined with epidural anesthesia in elderly patients with lower limb fracture

目的分析老年下肢骨折患者手术中腰麻-硬膜外联合麻醉的应用价值。方法选取本院2016年1月～2018年8月收治的老年下肢骨折患者62例,研究组(31例,腰麻-硬膜外联合麻醉)、对照组(31例,硬膜外麻醉)。比较感觉阻滞效果、运动阻滞效果、并发症。结果研究组的感觉阻滞持续用时、最大感觉阻滞用时均显著长于对照组(P <0.05),研究组感觉阻滞起效用时显著短与对照组(P <0.05);研究组最大感觉阻滞平面较对照组高(P <0.05);研究组最大运动阻滞持续用时显著长于对照组;研究组的最大运动阻滞用时和运动起效时均显著短于对照组,研究组并发症发生率显著较对照组低,差异有统计学意义(P <0.05)。结论腰麻-硬膜外联合麻醉应用于老年下肢骨折手术中,可有效缩短麻醉起效时间,且并发症较少,值得借鉴。

Objective To analyze application values of spinal anesthesia combined with epidural anesthesia in elderly patients with lower limb fracture. Methods 62 elderly patients with lower limb fractures who were admitted and treated in our hospital from January 2016 to August 2018 were selected.They were divided into the study group(31 cases,spinal anesthesia combined with epidural anesthesia) and the control group(31 cases,epidural anesthesia).Sensory block effect,motor block effect and complications were compared. Results The duration of sensory block and maximal sensory block in the study group were significantly longer than those in the control group(P < 0.05).Onset time of sensory block in the study group was significantly shorter than in the control group(P < 0.05).The maximal sensory block level in the study group was higher than that in the control group(P < 0.05).The duration of maximal motion block in the study group was significantly longer than that in the control group.Duration of maximal sensory block and onset time of sensory block of motor in the study group were both significantly shorter than those in the control group.The incidence of complications in the study group was significantly lower than that in the control group.The differences were statistically significant(P < 0.05). Conclusion Spinal anesthesia combined with epidural anesthesia in elderly patients with lower limb fractures can effectively shorten the onset time of anesthesia.In addition,it has fewer complications,which is worthy of learning.