腰硬联合阻滞麻醉对老年下肢骨折患者术中及术后相关指标的影响

Effect of combined lumbar and epidural anesthesia on intraoperative and postoperative indexes in elderly patients with lower limb fractures

目的分析腰硬联合阻滞麻醉对老年下肢骨折患者术中及术后相关指标的影响。方法选取2018年7月至2019年7月本院收治的100例老年下肢骨折手术患者,采取随机数表法分为两组,各50例。对照组接受硬膜外麻醉,观察组接受腰硬联合阻滞麻醉,观察比较两组患者麻醉效果(药物用量、麻醉起效用时、完全阻滞时间、麻醉后恢复用时)、手术指标(VAS评分、手术时间、住院时间、术中出血量)及呼吸功能[呼吸频率(RR)、血氧饱和度(SPO2)、每分通气量(MV)]。结果两组患者VAS评分、手术时间、住院时间、术中出血量差异无统计学意义;观察组药物用量、麻醉起效时间、完全阻滞时间、麻醉后恢复时间低于对照组,差异有统计学意义(P<0.05);麻醉后,观察组SPO2、MV高于对照组,RR低于对照组,差异有统计学意义(P<0.05)。结论老年下肢骨折患者采取腰硬联合阻滞麻醉,麻醉效果更佳,可有效降低患者肺部感染,缩短认知功能恢复时间,值得临床推广应用。

Objective To analyze the effect of combined lumbar and epidural anesthesia on intraoperative and postoperative indicators in elderly patients with lower limb fractures.Methods From July 2018 to July 2019,100 cases elderly patients with lower limb fracture were randomly divided into two groups,with 50 cases in each group.The control group received epidural anesthesia,the observation group accept waist hard joint block anesthesia.The anesthetic effect(drug dosage,onset time of anesthesia,total block time,recovery time after anesthesia),operation indexes(VAS score,operation time,hospitalization time,intraoperative blood loss)and respiratory function(RR,SpO2,MV)were observed and compared between two groups.Results There was no significant difference in VAS score,operation time,hospital stay and intraoperative blood loss between the two groups.The dosage of drugs in the observation group,the duration of complete block and the duration of recovery after anesthesia were lower than those in the control group,with significant difference(P<0.05).After anesthesia,SPO2 and MV in the observation group were higher than that in the control group,and RR was lower than that in the control group,with significant difference(P<0.05).Conclusion Elderly patients with lower limb fracture take combined spinal epidural anesthesia,anesthesia effect is better,can effectively reduce patients with pulmonary infection,shorten the recovery time of cognitive function,worthy of clinical application.