腰硬联合阻滞麻醉对老年下肢骨折手术患者麻醉效果及安全性的影响

The effect of combined spinal-epidural anesthesia on the anesthesia effect and safety of elderly patients with lower limb fracture surgery

目的分析腰硬联合阻滞麻醉对老年下肢骨折手术患者麻醉效果及安全性的影响。方法79例下肢骨折行手术治疗的老年患者,按随机数字表法分为对照组(39例)及研究组(40例)。对照组采用硬膜外麻醉,研究组使用腰硬联合阻滞麻醉。比较两组患者的麻醉情况、镇静效果、不良事件发生情况、生活质量。结果研究组麻醉起效时间(1.82±0.59)min、完全阻滞时间(12.98±2.02)min、麻醉后恢复时间(1.29±0.31)h均短于对照组的(5.33±2.71)min、(23.90±4.11)min、(1.63±0.55)h,麻醉药物用量(7.56±1.22)ml少于对照组的(16.17±2.75)ml,差异具有统计学意义(P<0.05)。研究组患者手术10、30 min的Ramsay镇静评分低于对照组,差异具有统计学意义(P<0.05)。研究组不良事件发生率为5.00%,低于对照组的23.08%,差异具有统计学意义(P<0.05)。治疗后,研究组患者的日常生活活动能力量表(ADL)评分(81.72±5.28)分高于对照组的(72.39±6.51)分,差异具有统计学意义(P<0.05)。结论下肢骨折行手术治疗的老年患者采用腰硬联合阻滞麻醉,其麻醉镇静效果佳,安全性高,值得在临床上推广使用。

Objective To analyze the effect of combined spinal-epidural anesthesia on the anesthesia effect and safety of elderly patients with lower limb fracture surgery.Methods A total of 79 patients with lower limb fracture surgery were divided into control group(39 cases)and research group(40 cases)according to random numerical table.The control group received epidural anesthesia,and the research group received combined spinal-epidural anesthesia.The anesthesia status,sedative effect,occurrence of adverse events,and quality of life were compared between the two groups.Results The onset time of anesthesia(1.82±0.59)min,complete block time(12.98±2.02)min and recovery time after anesthesia(1.29±0.31)h in the research group were shorter than(5.33±2.71)min,(23.90±4.11)min,(1.63±0.55)h in the control group,and the dosage of anesthetic drugs(7.56±1.22)ml was less than(16.17±2.75)ml in the control group.All the difference was statistically significant(P<0.05).The Ramsay scores 10 and 30 min after surgery of the research group were lower than those of the control group,and the difference was statistically significant(P<0.05).The incidence of adverse events of the research group was 5.00%,which was lower than 23.08%of the control group,and the difference was statistically significant(P<0.05).After treatment,the activities of daily living(ADL)score(81.72±5.28)points of the research group was higher than(72.39±6.51)points of the control group,and the difference was statistically significant(P<0.05).Conclusion Combined spinal-epidural anesthesia shows good anesthetic sedation effect and high safety for elderly patients with lower limb fracture surgery,which is worthy of clinical popularization and application.