椎管内麻醉对高龄髋关节置换患者术后认知功能及留观时间的影响

Effects of Spinal Canal Anesthesia on Postoperative Cognitive Function and Observation Time in Elderly Patients with Hip Arthroplasty

目的探讨椎管内麻醉对高龄髋关节置换患者术后认知功能及留观时间的影响。方法87例行髋关节置换术的高龄患者随机分为两组。对照组43例采用气管插管全麻,观察组44例采用椎管内麻醉,比较两组的临床结局。结果观察组的留观时间短于对照组(P<0.01)。术后6 h,观察组的MMSE评分高于对照组,VAS评分低于对照组(P<0.01)。出现麻醉平面后,观察组DBP、SBP水平的降低幅度显著小于对照组(P<0.01)。两组的并发症发生率无统计学差异(P>0.05)。结论高龄髋关节置换患者行椎管内麻醉能缩短留观时间,降低对患者血压水平和认知功能的影响,并发症少。

Objective To explore the effects of spinal canal anesthesia on postoperative cognitive function and observation time in elderly patients with hip arthroplasty.Methods 87 elderly patients with hip arthroplasty were randomly divided into two groups.43 cases of control group received general anesthesia with tracheal intubation,and 44 cases of observation group received spinal canal anesthesia.The clinical outcomes of two groups were compared.Results The observation time of observation group was shorter than that of control group(P<0.01).At 6 hours after surgery,the MMSE score of observation group was higher than that of control group,and the VAS score was lower than that of control group(P<0.01).After the appearance of anesthesia level,the reduction ranges of DBP and SBP levels of observation group were smaller than those of control group(P<0.01).No significant difference was found in the incidence of complications between two groups(P>0.05).Conclusions Spinal canal anesthesia applied in elderly patients with hip arthroplasty can shorten the observation time,reduce the impact on patients'blood pressure level and cognitive function,with few complications.