针刺联合硬膜外麻醉对老年下肢骨折手术患者麻醉效果及循环功能的影响

Effect of Acupuncture Combined with Epidural Anesthesia on Anesthesia and Circulatory Function in Elderly Patients Undergoing Lower Extremity Fracture Surgery

目的:观察针刺联合硬膜外麻醉对老年下肢骨折手术患者麻醉效果及循环功能的影响。方法:将80例下肢骨折行骨科手术的老年患者按随机数字表法分为对照组和观察组各40例。对照组行硬膜外麻醉,观察组在对照组基上联合针刺麻醉。比较2组麻醉效果、疼痛程度、循环功能及麻醉药物用量。结果:观察组麻醉优良率97.50%,高于对照组82.50%(P<0.05)。切皮时(T时刻),2组视觉模拟评分法(VAS)评分均较麻醉前(T时刻)降低(P<0.05),观察组VAS评分低于对照组(P<0.05);手术开始后1 h (T时刻),2组VAS评分均较T时刻升高(P<0.05),对照组VAS评分升高更明显(P<0.05);手术结束时(T时刻),2组VAS评分均较T时刻下降(P<0.05),组间比较,差异无统计学意义(P>0.05)。T、T时刻,2组心率(HR)、舒张压(DBP)、收缩压(SBP)、平均动脉压(MAP)均较T时刻上升(P<0.05),观察组HR、DBP、SBP、MAP上升幅度均小于对照组(P<0.05);T时刻,2组HR、DBP、SBP、MAP均较同组T、T时刻下降(P<0.05),2组HR、DBP、SBP、MAP与同组T时刻比较,差异均无统计学意义(P>0.05)。观察组硬膜外麻醉药物每小时平均用量及总用量均少于对照组(P<0.05)。结论:将针刺麻醉与硬膜外麻醉联合应用于老年下肢骨折患者术中可提升麻醉效果,减轻其术中疼痛感,稳定循环功能,减少麻醉药物用量。

Objective:To observe the effect of acupuncture combined with epidural anesthesia on anesthesia and circulatory function in elderly patients undergoing lower extremity fracture surgery.Methods:A total of 80 elderly patients with undergoing lower extremity fracture surgery were randomly divided into the control group and the observation group,with 40 cases in each group.The control group received epidural anesthesia,and the observation group received acupuncture anesthesia based on the treatment of the control group.The anesthetic effect,pain degree,circulatory function and anesthetic drug dosage were compared between the two groups.Results:The good-and-moderate rate of anesthesia in the observation group was 97.50%,higher than that of 82.50%in the control group(P<0.05).At the time of skin incision(T),the Visual Analogue Scale(VAS) scores in the two groups were decreased when compared with those before anesthesia(T)(P<0.05),and the VAS score in the observation group was lower than that in the control group(P<0.05);one hour after the start of the surgery(T),the VAS scores in both groups were increased when compared with those at T(P<0.05),and the VAS score in the control group was higher(P<0.05);at the end of surgery(T),the VAS scores in the two groups were decreased when compared with those at T(P<0.05),there being no significant difference between the two groups(P>0.05).At Tand T,the heart rate(HR),diastolic blood pressure(DBP),systolic blood pressure(SBP) and mean arterial pressure(MAP) in the two groups were increased when compared with those at T(P<0.05),and the increase of HR,DBP,SBP and MAP in the observation group were lower than those in the control group(P<0.05);at T,the HR,DBP,SBP and MAP in the two groups were decreased when compared with those in the same group at Tand T(P<0.05),but there being no significant difference in the comparison of HR,DBP,SBP and MAP in the observation group when compared with those in the same group at T(P>0.05).The average dosage per hour and average dosage per case of epidural anesthesia in the observation group were lower than those in the control group(P<0.05).Conclusion:The therapy of acupuncture and epidural anesthesia for elderly patients undergoing lower extremity fracture surgery can improve the anesthetic effect,reduce the intraoperative pain,stabilize the circulatory function,and reduce the amount of anesthetic drugs.