布比卡因蛛网膜下腔-硬膜外在老年下肢骨折麻醉中的价值及作用

Value and Role of Bupivacaine in Subarachnoid Epidural Anesthesia for Lower Limb Fractures in Elderly

目的:探讨布比卡因蛛网膜下腔-硬膜外在老年下肢骨折麻醉中的价值及作用。方法:选取2020年6月-2021年6月佳木斯市中医医院收治的128例老年下肢骨折患者,按照随机数字表法分为两组,每组64例。对照组实施连续硬膜外麻醉,研究组实施布比卡因蛛网膜下腔-硬膜外麻醉。观察分析两组麻醉效果、并发症发生情况、麻醉指标、生命体征及VAS评分情况。结果:研究组麻醉优良率高于对照组,并发症发生率低于对照组(P<0.05)。研究组麻醉见效时间短于对照组,麻醉药物使用剂量少于对照组(P<0.05)。两组麻醉后30 min MAP、HR、RR比较,差异均有统计学意义(P<0.05),两组麻醉后30 min SpO2比较,差异无统计学意义(P>0.05)。研究组手术结束时、术后6、24 h的VAS评分均低于对照组(P<0.05)。结论:老年下肢骨折患者使用布比卡因蛛网膜下腔-硬膜外麻醉效果显著,并发症少,可有效改善其生命体征,减轻疼痛,具有较高的安全性,值得应用。

Objective:To investigate the value and role of Bupivacaine in subarachnoid epidural anesthesia for lower limb fractures in the elderly.Method:A total of 128 elderly patients with lower limb fractures treated in Jiamusi Hospital of Traditional Chinese Medicine from June 2020 to June 2021 were randomly divided into two groups according to the random number table method,64 cases in each group.The control group was given continuous epidural anesthesia and the study group was given Bupivacaine subarachnoid epidural anesthesia.The anesthetic effect,complications,anesthetic indexes,vital signs and VAS score of two groups were observed and analyzed.Result:The excellent rate of anesthesia in the study group was higher than that in the control group,and the complication rate was lower than that in the control group(P<0.05).The effective time of anesthesia of the study group was shorter than that of the control group,and the dosage of anesthetic drugs was less than that of the control group(P<0.05).There were statistically significant differences in MAP,HR and RR between two groups at 30 min after anesthesia(P<0.05),while there was no statistically significant difference in SpO;between two groups at 30 min after anesthesia(P>0.05).The VAS scores of the study group at the end of surgery,6 and 24 h after surgery were lower than those of the control group(P<0.05).Conclusion:Bupivacaine subarachnoid epidural anesthesia for elderly patients with lower limb fractures has significant effect and less complications,it can effectively improve their vital signs and reduce pain,it has high safety and is worthy of application.