喉罩通气全麻与腰硬联合麻醉对老年股骨颈骨折内固定术患者的镇痛效果比较

Comparison of the analgesic effects of laryngeal mask ventilation general anesthesia and combined spinal epidural anesthesia in elderly patients with femoral neck fracture undergoing internal fixation

目的比较喉罩通气全麻与腰硬联合麻醉对老年股骨颈骨折内固定术患者的镇痛效果。方法选取2017年1月至2020年12月收治的68例老年股骨颈骨折内固定术患者为研究对象,遵循数字随机表法将其分为对照组(n=34)和研究组(n=34)。对照组开展腰硬联合麻醉,研究组开展喉罩通气全麻。比较两组的麻醉效果。结果T_(2)、T_(3)时,研究组的HR、MAP、收缩压、舒张压均高于对照组(P<0.05)。T_(1)、T_(2)、T_(3)时,研究组的血清儿茶酚胺、皮质醇水平均低于对照组(P<0.05)。研究组的麻醉起效时间、术毕至苏醒时间均短于对照组(P<0.05)。研究组的麻醉总有效率高于对照组(P<0.05)。结论与腰硬联合麻醉比较,于老年股骨颈骨折内固定术中开展喉罩通气全麻的麻醉效果及安全性更为显著。

Objective To compare the analgesic effects of laryngeal mask ventilation general anesthesia and combined spinal epidural anesthesia in elderly patients with femoral neck fracture undergoing internal fixation.Methods A total of 68 cases of elderly patients with femoral neck fracture undergoing internal fixation treated from January 2017 to December 2020 were selected as the research objects,and the patients were divided into control group(n=34)and study group(n=34)according to the digital random table method.The control group was given combined spinal epidural anesthesia,and the study group was given laryngeal mask ventilation general anesthesia.The anesthetic effects of the two groups were compared.Results At T_(2) and T_(3),the HR,MAP,systolic blood pressure and diastolic blood pressure of the study group were higher than those of the control group(P<0.05).At T_(1),T_(2) and T_(3),the serum catecholamine and cortisol levels of the study group were lower than those of the control group(P<0.05).The onset time of anesthesia and the time from completion of surgery to awakening in the study group were shorter than those in the control group(P<0.05).The total effective rate of anesthesia in the study group was higher than that in the control group(P<0.05).Conclusion Compared with combined spinal epidural anesthesia,laryngeal mask ventilation general anesthesia during internal fixation of femoral neck fractures in the elderly is more effective and safer.