椎管内麻醉与全身麻醉对老年骨科手术患者的影响

Effect of Intraspinal and General Anesthesia on ElderlyPatients UndergoingOrthopedic Surgery

目的比较全身麻醉与椎管内麻醉对老年骨科手术患者的影响。方法选取2018年1月至2019年3月常熟市中医院骨科收治的108例患者作为研究对象,用奇数偶数分组法分为观察组和对照组,各54例。两组均给予手术治疗,对照组术中采取全身麻醉,观察组术中采取椎管内麻醉,比较两组麻醉效果。结果两组患者麻醉时间、手术时间、术中出血量相比较,差异无统计学意义(P>0.05);观察组的睁眼时间、语言陈述时间均短于对照组,差异有统计学意义(P<0.05);两组术前简易精神状态评价量表(MMSE)评分相比,差异无统计学意义(P>0.05);观察组术后不同时间MMSE评分均高于对照组;观察组麻醉不良反应发生率为5.56%低于对照组的18.52%,差异有统计学意义(P<0.05)。结论与全身麻醉相比,椎管内麻醉可提高老年骨科手术患者术后MMSE评分,缩短睁眼和语言陈述时间,不良反应少,安全性更高。

Objective To compare the effects of general anesthesia and spinal anesthesia on elderly patients undergoing orthopedic surgery.Methods A total of 108 patients admitted to the department of Orthopedics of Changshu Chinese Medicine Hospital(New District Hospital)from January 2018 to March 2019 were selected as the subjects of the study.The two groups were given surgical treatment,the control group was given general anesthesia during the operation,the observation group was given intravertebral anesthesia during the operation,and the anesthetic effect of the two groups was compared.Results There were no statistically significant differences between the two groups in anesthesia time,operation time and intraoperative blood loss(P>0.05).The time of eye opening and speech presentation in the observation group were shorter than those in the control group,with statistically significant differences(P<0.05).Compared with the preoperative MMSE scores,there was no statistically significant difference(P>0.05).The MMSE scores of the observation group were higher than that of the control group at different times after operation.The incidence of anaesthesia adverse reaction in the observation group was 5.56%lower than that in the control group 18.52%,the difference was statistically significant(P<0.05).Conclusion Compared with general anesthesia,intra-spinal anesthesia can improve postoperative MMSE score,shorten the time of opening eyes and speech presentation,have fewer adverse reactions and be safer in elderly patients undergoing orthopaedic surgery.