不同比重布比卡因单侧蛛网膜下腔麻醉在老年髋部手术患者中的应用效果

Application Effect of Unilateral Subarachnoid Anesthesia of Bupivacaine at Different Specific Gravities in Elderly Patients with Hip Surgery

目的:探讨不同比重布比卡因单侧蛛网膜下腔麻醉在老年髋部手术患者中的应用效果。方法:选取2020年7月—2022年2月于新沂东方医院骨科行髋部手术的63例老年髋部骨折患者作为研究对象,以随机数字表法分为试验组(n=33)和对照组(n=30)。两组均实施单侧蛛网膜下腔腔麻醉,试验组应用轻比重布比卡因,对照组应用重比重布比卡因。比较两组麻醉效果。结果:麻醉后20 min、术后2 h,两组平均动脉压、血氧饱和度低于麻醉前,但试验组高于对照组,差异有统计学意义(P<0.05);两组各时间段心率以及麻醉起效时间、麻醉阻滞完全时间、有效镇痛时间和运动阻滞时间比较,差异无统计学意义(P>0.05)。试验组不良反应发生率低于对照组,差异有统计学意义(P=0.029)。结论:轻比重布比卡因单侧蛛网膜下腔麻醉在老年髋部手术患者中的应用效果显著,可在不影响麻醉效果的情况下减小对患者平均动脉压、血氧饱和度的影响,减少不良反应。

Objective:To investigate the application effect of unilateral subarachnoid anesthesia of bupivacaine at different specific gravities in elderly patients undergoing hip surgery.Methods:A total of 63 elderly patients with hip fracture who underwent hip surgery in the Department of Orthopedics of Xinyi Dongfang Hospital from July 2020 to February 2022 were selected as the study subjects and divided into the experimental group(n=33)and the control group(n=30)by random number table method.Unilateral subarachnoid anesthesia was performed in two groups,with bupivacaine at low specific gravity in the experimental group and bupivacaine at high specific gravity in the control group.The anesthetic effect was compared between the two groups.Results:The mean arterial pressure and oxygen saturation in the two groups at 20 min and 2 h after anesthesia were lower than those before anesthesia,but the experimental group was higher than the control group,and the difference was statistically significant(P<0.05).There was no significant difference in heart rate at each time period,anesthesia onset time,complete anesthesia block time,effective analgesia time and movement block time between the two groups(P>0.05).The incidence of adverse reactions in the experimental group was lower than that in the control group,and the difference was statistically significant(P=0.029).Conclusion:Unilateral subarachnoid anesthesia using bupivacaine at low specific gravity has a significant application effect in elderly patients undergoing hip surgery,which can reduce the effect on mean arterial pressure and oxygen saturation of patients and reduce adverse reactions without affecting the anesthesia effect.