全身麻醉与腰-硬联合麻醉在老年骨科手术患者的临床效果研究

Clinical Effect of General Anesthesia and Combined Spinal and Epidural Anesthesia in Elderly Patients Undergoing Orthopedic Surgery

目的研究全身麻醉和腰-硬联合麻醉对老年骨科手术患者的应用效果。方法选取该院在2016年3月—2018年2月期间收治的74例老年骨科手术患者,按双色球随机分组法分成参照组和实验组,每组各37例。其中参照组为患者使用全身麻醉,实验组为患者使用腰-硬联合麻醉,对两组麻醉效果进行分析比较。结果实验组患者感觉阻滞持续时间、麻醉起效时间、运动神经阻滞持续时间、阵痛维持时间等麻醉指标分别为(47.33±7.69)min、(12.34±3.45)min、(162.45±16.33)min、(130.73±10.42)min,均要优于参照组(35.32±4.42)min、(5.44±2.55)min、(93.01±15.56)min、(172.56±19.78)min,差异有统计学意义(t=8.236、9.783、18.726、11.373,P<0.05)。实验组的头晕、瘙痒、呕吐等不良反应为5.41%,低于参照组的21.62%(χ^2=4.162,P<0.05)。结论对老年骨科手术患者使用腰-硬联合麻醉效果显著,具有不良反应少、麻醉起效快、阵痛时间长等特点,值得大力推广。

Objective To study the effect of general anesthesia and combined spinal and epidural anesthesia on elderly orthopedic patients.Methods A total of 74 elderly orthopaedic patients who were treated in our hospital from March 2016 to February 2018 were selected and divided into a reference group and an experimental group according to the two-color ball random grouping method,with 37 cases in each group.The reference group used general anesthesia for patients,and the experimental group used lumbar-rigid anesthesia for patients.The anesthesia effects of the two groups were analyzed and compared.Results The anesthesia indexes such as sensory block duration,anesthesia onset time,motor nerve block duration,and paroxysmal maintenance time in the experimental group were(47.33±7.69)min,(12.34±3.45)min,(162.45±16.33)min,(130.73±10.42)min,which were all better than those in the reference group(35.32±4.42)min,(5.44±2.55)min,(93.01±15.56)min,(172.56±19.78)min,the difference was statistically significant(t=8.236,9.783,18.726,11.373,P<0.05).Dizziness,pruritus,vomiting and other adverse reactions in the experimental group were 5.41%,which was lower than 21.62%in the reference group(χ^2=4.162,P<0.05).Conclusion The combined spinal and epidural anesthesia is effective for elderly patients undergoing orthopaedic surgery.It has the characteristics of less adverse reactions,fast onset of anesthesia,and long period of pain.