全麻与腰硬联合麻醉对老年髋部手术患者的影响对比

Comparison of the Effect of General Anesthesia and Combined Spinalepidural Anesthesia on Elderly Patients with Hip Surgery

目的 对比探讨老年患者髋部手术时采取全麻与腰硬联合麻醉的效果及对患者的影响。方法 随机选择2018年1月—2021年10月于该院接受髋部手术治疗的老年患者60例,根据抛硬币形式分成观察组(正面,30例)与对照组(背面,30例)。对照组实施气管插管全麻,观察组采取腰硬联合麻醉,记录比较两组患者麻醉质量,监测各组患者麻醉后不同时间心率、血压等生理指标变化,统计两组患者发生不良反应的总发生率。结果观察组患者麻醉起效时间(50.74±11.21)s、完全阻滞时间(15.12±3.95)s均明显短于对照组,且麻醉药物用量(18.24±3.95)mg少于对照组,差异有统计学意义(t=55.091、8.706、114.575,P<0.05)。两组患者T0(麻醉前)、T3(术毕)时间测定心率、血压指标差异无统计学意义(P>0.05),观察组患者T1(麻醉30 min)、T2(麻醉1 h)心率测定结果低于对照组,收缩压、舒张压高于对照组,差异有统计学意义(P<0.05)。观察组患者不良反应总发生率3.33%低于对照组,差异有统计学意义(χ^(2)=4.706,P<0.05)。结论 老年患者实施髋部手术治疗时首选腰硬联合麻醉方案,具有起效快、对患者影响小、安全性高等优点,提倡运用推广。

Objective To compare the effects of general anesthesia and combined spinal-epidural anesthesia during hip surgery in elderly patients and their impact on patients.Methods Randomly selected 60 elderly patients who received hip surgery in this hospital from January 2018 to October 2021.They were divided into observation group(heads,30 cases) and control group(tails,30 cases) according to the form of coin tossing.The control group received general anesthesia with endotracheal intubation,and the observation group received combined spinal-epidural anesthesia.The anesthesia quality of the two groups of patients was recorded and compared,and the changes of physiological indicators such as heart rate and blood pressure at different times after anesthesia in each group were monitored.The total incidence of adverse reactions in the two groups was calculated.Results The onset time of anesthesia(50.74±11.21) s and the complete block time(15.12±3.95) s in the observation group were significantly shorter than those in the control group,and the amount of anesthesia drug(18.24±3.95) mg was less than that of the control group,the difference was statistically significant(t=55.091,8.706,114.575,P<0.05).There was no statistically significant difference in the heart rate and blood pressure indexes measured at T0(before anesthesia) and T3(after the operation) between the two groups(P>0.05).The heart rate measurement results of T1(30 min anesthesia) and T2(1h anesthesia) in the observation group were lower than those in the control group,the systolic blood pressure and diastolic blood pressure were higher than those in the control group,the difference was statistically significant(P <0.05).The total incidence of adverse reactions in the observation group was 3.33% lower than that in the control group,the difference was statistically significant(χ^(2)=4.706,P<0.05).Conclusion Combined spinal-epidural anesthesia is the first choice for elderly patients undergoing hip surgery.It has the advantages of quick onset,little impact on patients,and high safety.It is recommended to be used and popularized.