全麻复合腰硬联合麻醉用于老年患者髋关节置换术的临床研究

目的 探讨全麻复合腰硬联合麻醉在老年患者髋关节置换术的应用效果。方法 随机抽取该院2012年2月—2013年8月共收治的60例行髋关节置换术老年患者,将其分为观察组与对照组。两组均给予全身麻醉,观察组在全身麻醉基础上加腰硬联合麻醉,对比两组的麻醉效果。结果 观察组的低血压、高血压、术后躁动发生率分别为23.3%、36.7%、36.7%,参照组的分别为63.3%、80.0%、83.3%,观察组的低血压、高血压及术后躁动发生率显著低于对照组;观察组的术后苏醒时间为（15.4±6.2）min,对照组则为（40.3±8.2）min,观察组苏醒时间明显少于对照组;两组比较差异有统计学意义（P〈0.05）;两组的出血量则差异无统计学意义（P〉0.05）。结论 全麻复合腰硬联合麻醉应用于老年患者髋关节置换术,效果显著,值得在临床推广。     

腰硬联合麻醉和全身麻醉在老年患者股骨颈骨折手术麻醉分析

目的:探讨腰硬联合麻醉和全身麻醉在老年患者股骨颈骨折手术麻醉。方法:选择我院在2017年1月-2018年12月收集的股骨颈骨折手术老年患者30例进行研究分析,按照随机教字表分组方式将股骨颈骨折手术老年患者分为腰硬麻醉组和全身麻醉组各15例,全身麻醉组股骨颈骨折手术老年患者给予全身麻醉.腰硬麻醉组股骨颈骨折手术老年患者给予腰硬联合麻醉,诱导前、术中以及术后30分钟测定2组血糖情况,记录2组股骨颈骨折手术老年患者的麻醉药物用量,记录麻醉维持时长,并比较2组的术中和术后不良反应情况。结果:腰硬麻醉组股骨颈骨折手术老年患者血糖低于全身麻醉组,麻醉维持时间长,药物用量少,數据统计P<0.05。腰硬麻醉组术中和术后的不良反应低于全身麻醉组,数据统计P<0.05。其中,腰硬麻醉组的术中出现低血压有1例,出现高血压0例,出现心动过缓1例,总发生率是13.33%。全身麻醉组的术中出现低血压有2例,出现高血压2例,出现心动过缓2例,术后出现恶心呕吐2例,肺部感染1例,总发生率是60.00%。结论:在股骨颈骨折手术的治疗中,腰硬联合麻醉的麻醉效果显著优于全身麻醉,药物用量少,安全性高,值得应用。     

腰硬联合麻醉复合全身麻醉对老年髋关节置换术患者苏醒期躁动及认知功能的影响

目的探讨腰硬联合麻醉复合全身麻醉在老年髋关节置换术(THA)患者中的应用效果。方法选取2018年8月-2021年8月我院收治的40例老年THA患者,依照随机数字表法分为对照组(n=20)和观察组(n=20)。对照组予以全身麻醉,观察组予以腰硬联合麻醉复合全身麻醉。比较两组麻醉效果、生命体征变化、术后恢复情况、认知功能及苏醒期躁动情况。结果观察组麻醉优良率高于对照组(P<0.05);观察组手术切皮前1 min(T1)、缝合切口时(T2)心率(HR)、平均动脉压(MAP)低于对照组,观察组术后恢复情况较对照组好(P<0.05);两组简易精神量表(MMSE)评分术后24 h低于术前,观察组高于对照组(P<0.05);观察组苏醒期躁动发生率较对照组低(P<0.05)。结论腰硬联合麻醉复合全身麻醉可提高老年THA患者麻醉效果,维持术中生命体征稳定,缩短术后呼吸恢复、定向力恢复时间,减少术后苏醒期躁动发生,且对认知功能影响小。     

腰硬联合麻醉和全身麻醉在老年患者股骨颈骨折手术的麻醉观察

目的 探讨腰硬联合麻醉和全身麻醉在老年患者股骨颈骨折手术治疗中的麻醉效果.方法 股骨颈骨折老年患者80例,随机分为腰硬联合麻醉观察组和全身麻醉组,各40例.记录患者麻醉中低血压、高血压、心动过缓、缺氧和出血情况,询问患者麻醉满意度和主刀医师满意度.记录患者术后镇痛效果、发生恶心呕吐、头晕嗜睡、肺部感染情况.结果 与全麻组比较,腰硬联合麻醉组低血压发生率高(P＜0.05),而高血压发生率低(P＜0.05),心动过缓、缺氧、出血量、患者麻醉满意度和主刀医师满意度差异无统计学意义(P＞0.05);与全麻组比较,腰硬联合麻醉组术后6 h VAS评分、恶心呕吐、头晕嗜睡和肺部感染发生率明显低(P＜0.05).结论 股骨颈骨折手术患者,全身麻醉和腰硬联合麻醉均能提供良好的麻醉和术后镇痛,而腰硬联合麻术后镇痛效果更好,并发症更少.     

两种麻醉方式用于髋关节置换术的临床比较

目的:探讨腰—硬联合麻醉和全身麻醉在髋关节置换术中的影响。方法:选择髋关节置换术患者80例,按随机化原则分为全身麻醉组40例和腰—硬联合麻醉组40例,比较两组的临床效果。结果:腰—硬联合麻醉组患者的血液动力学较全身麻醉组稳定,腰—硬联合麻醉组患者术后血压、心率显著低于全身麻醉组和术前,差异有统计学意义(P<0.05),全身麻醉组血压、心率术后较术前相比显著下降,差异有统计学意义(P<0.05);腰—硬联合麻醉组患者清醒时间较全身麻醉组短,腰—硬联合麻醉组的麻醉药量较全身麻醉组少,腰—硬联合麻醉组的深层静脉栓塞发生率低于全身麻醉组,两组比较,差异有统计学意义(P<0.05)。结论:髋关节置换术中运用腰—硬联合麻醉较全身麻醉效果好,清醒时间短,麻醉药量少,血液动力学稳定,值得临床推广应用。     

腰硬联合麻醉和全身麻醉在老年股骨颈骨折手术中的应用观察

目的：观察腰硬联合麻醉和全身麻醉在老年股骨颈骨折手术中的应用效果。方法将我院86例老年股骨颈骨折患者按照平行分组法分为联合组（43例）和全身组（43例）,分别给予腰硬联合麻醉和全身麻醉,分析2组患者的麻醉效果。结果联合组术中高血压发生率低于全身组,低血压发生率高于全身组（P〈0.05）,联合组镇痛效果及术后并发症等少于全身组（P〈0.05）。结论腰硬联合麻醉和全身麻醉在老年股骨颈骨折手术中均可取得较为显著的麻醉效果,腰硬联合麻醉效果更佳,术后并发症少,可作为老年股骨颈骨折手术的理想麻醉方式。     

三种麻醉方法在高龄患者全髋置换术中应用的比较研究

目的比较腰-硬联合麻醉、硬膜外麻醉与全身麻醉在高龄患者全髋关节置换术中的临床应用.方法 80岁以上行单侧全髋关节置换术患者60例,随机分为两组：A组（腰-硬联合麻醉组,n=20）,B组（硬膜外麻醉组n=20）,C组（全身麻醉组,n=20）,观察三组患者术中血流动力学变化,记录术中镇静药、升压药、降压药使用率及麻醉起效时间、手术时间、苏醒时间、在PACU停留时间.结果三组患者血流动力学变化差异无统计学意义（P〉0.05）;苏醒时间、PACU停留时间C组明显长于A组（P〈0.01）,B组PACU停留时间也长于A组（P〈0.05）;术中C组使用镇静药、升压药、降压药例数明显多于A组（P〈0.05）,B组使用镇静药例数也明显多于A组（P〈0.05）.结论与硬膜外麻醉和全身麻醉相比,腰-硬联合麻醉具有一定的优势,更适用于高龄患者全髋关节置换术.     

腰硬联合麻醉和全身麻醉在老年患者股骨颈骨折手术中的应用价值分析

目的:探讨腰硬联合麻醉和全身麻醉在老年患者股骨颈骨折手术中的应用效果进行分析。方法:选择我院进行股骨颈骨折手术的老年患者80例,随机划分为A组和B组各40例,A组在手术实施前实施全身麻醉,B组在手术前实施腰硬联合麻醉,比较2组在麻醉过程中的血压、心动和术中出血量、术后的并发症等情况,并进行观察记录。结果:2组通过比较分析,B组的低血压的发生率显著高于A组,而高血压的发生率明显低于A组,比较差异具有统计学意义(P0.05),心动过缓、缺氧差异不明显(P0.05)。患者在术后进行VAS评分,B组的VAS评分明显低于A组,比较差异具有统计学意义(P0.05),术中出血量差异不明显(P0.05)。B组患者在术后的并发症发生率明显低于A组,比较差异具有统计学意义(P0.05)。结论:全身麻醉以及腰硬联合麻醉均为股骨颈骨折手术的老年患者提供有效的麻醉以及镇痛,但腰硬联合麻醉的术后并发症少于全身麻醉,而且效果理想,对术中的控制有帮助,值得临床借鉴应用。     

腰-硬联合麻醉在高龄患者髋关节置换术中的应用效果

目的探讨腰-硬联合麻醉在高龄患者髋关节置换术中的应用效果。方法选择包头医学院第一附属医院2009年7月至2013年1月择期接受髋关节置换术的患者135例,采用随机数字表法分为A、B、C 3组,麻醉方式分别为全身麻醉、硬膜外麻醉和腰-硬联合麻醉,各45例。观察B组和C组局部麻醉药物用量、感觉阻滞起效时间、阻滞完善时间及痛觉恢复时间;比较3组的麻醉和镇痛效果、血流动力学变化及麻醉不良反应。结果 C组的局部麻醉药物用量明显少于B组(P<0.05),感觉阻滞起效时间和阻滞完善时间均显著较B组快(P<0.01);A组和C组的麻醉效果优于B组(P<0.05),但B组和C组的术中血流动力学改变患者比例低,术后镇痛效果优于A组,术后不良反应发生率低于A组(P<0.01)。结论腰-硬联合麻醉用于高龄患者髋关节置换术中是安全、可靠的。     

腰硬联合麻醉对老年股骨颈骨折患者术后恢复的影响

目的探讨腰硬联合麻醉对老年股骨颈骨折患者术后恢复的影响。方法选取2017年1月至2018年4月舞钢市人民医院收治的94例老年股骨颈骨折患者,按随机数表法分为A组和B组,每组47例。两组患者均接受人工髋关节置换术治疗,A组患者术中行全身麻醉,B组患者行腰硬联合麻醉。比较两组患者麻醉苏醒时间。采用视觉模拟评分(VAS)评估患者术后1、3 d的疼痛感。采用简易智力状态检查(MMSE)量化表评价患者术前、术后1 d和术后3 d的认知水平。结果 B组患者麻醉苏醒时间短于A组,差异有统计学意义(P<0.05)。B组患者术后1、3 d的VAS评分低于A组,差异有统计学意义(P<0.05)。术后1、3 d,B组患者MMSE评分高于A组,差异有统计学意义(P<0.05)。结论对老年股骨颈骨折患者术中采用腰硬联合麻醉,可有效降低患者术后疼痛感,减少认知功能障碍的发生。     

Anesthesia

<正>209016 Effects of flurbiprofen on cellular immune function during patient-controlled intravenous analgesia with fentanyl in patients after esophagectomy/Feng Yanping(冯艳平,Dept Anesthesiol,Cancer Hosp He’nan Province,Zhengzhou 450003)…∥Chin J Anesthesiol. -2009,29(9). -773～774 Objective To investigate the effects of flurbiprofen on cellular immune function during patient-controlled in- travenous analgesia(PCIA) with fentanyl in the patients after esophagectomy.     

Anesthesia

<正>209163 Changes in plasma colloid osmotic pressure during off-pump orthotopic liver transplantation/Zhang Xiaomei(Dept Anesthesiol,Tianjin 1st Centre Hosp,Tianjian 300192)…∥Chin J Anesthesiol.-2009,29(2).-151~153Objective To investigate the changes in plasma colloid osmotic pressure(COP)in patients undergoing off-pump orthotopic liver transplantation(OLT).Methods Thirty ASA Ⅱ-Ⅳ patients(liver function Child-Pugh grade B or C)aged 35-60 yr undergoing off-pump OLT were studied.Anesthesia was induced with midazolam,sufentanil,propofol and vecuronium and maintained with propofol infusion,isoflurane inhalation and intermittent iv boluses of sufentanil and vecuronium.Human albumin and fresh frozen plasma were infused during operation.Hemoglobin was maintained at 70-80 and 80-100 g/L during preanhepatic and anhepatic phase respectively.Urine output was maintained at 1,0.5 and 1-2 ml·kg-1·min-1 while CVP at 4-7,0-3 and 4-10 mm Hg respectively during preanhepatic,anhepatic and neo-hepatic phase.Blood samples were taken immediately before intravenous line was established (T0,baseline),at skin incision(T1),60 min of preanhepatic phase(T2)beginning of anhepatic phase(T3),30 min of anhepatic phase (T4),beginning of neohepatic phase(T5),30 min of neohepatic phase(T6) and the end of operation(T7)from internal jugular vein for determination of plasma COP,crystalloid osmotic pressure and serum albumin concentration.     

Anesthesia

Anesthetic choice for patients undergoing simuitaneous pancreas-kidney transplantation,Effect of morphine pretrealment on expression of substance P and calcitonin gene related peptide in myocardium following acute myocardial ischemia in rats,Effects of lidocaine and ropivacaine on con- tractility of isolated pregnarlt rat myometrium,Effect of acute hypervolemic hemodilution with different colloids on GP Ⅱ b/Ⅲ a and P-selectin expression in patients with colon cancer during perioperative period,Effects of propofol on extracellular signal-regulated kinase 1/2 phosphorylation in mouse hippocampal slices[第一段]     

Anesthesia

Preventive effects of remifentanil on sympathetic activation induced by desflurane,Effects of different doses of ketamine on cognitive function in aged rats,Efficacy of sufentanil combined with propofol for video-assisted endoscopic transthoracic sympathectomy,Accuracy of target-controlled infusion of sufentanil in clinical anesthesia.     

Anesthesia

Cerebral protective effect of nicorandil premedication in patients undergoing coronary artery bypass grafting with cardiopuimonary bypass;Protective effects of remifentanil preconditioning on myocardium against ischemia-reperfusion injury in rats; Effects of ultrarapid opiate detoxification during general anesthesia on plasma morphine concentration and brain β-endorphin content in rats addicted to morphine;The effect of propofol on platelet aggregation and blood coagulation in patients undergoing upper ab- dominal surgery/Tao Guocai ; Protective effects of pretreatment with rosigli tazone on the lungs against endotoxin-induced acute injm＇y in rats; ……     

Anesthesia

<正>209480 Effect of high thoracic epidural block on expression of β1-ARK mRNA in lymphocytes in elderly patients with essential hypertension complicated with     

Anesthesia

206524Security evaluation of bupivacaine ,ropivacainecombined with fentanyl in postoperative continuousepidural analgesia/ Wan Xiaohong(万晓红,Dept SICU,2nd Affil Hosp,Kunming Med Col ,Kunming 650101)…∥Chin J Surg.-2006 ,44(17) .-1200 ~1202ObjectiveTo investigate the effects,side-effectsand security of bupivacaine ,ropivacaine combinated withfentanyl in postoperative continuous epidural analgesia.MethodsA total of 1 600 postoperative continuousepidural analgesia patients receiving dif…     

Anesthesia

Efficacy and safety of intravenous dexmedetomidine as an adjunct to general anesthesia; Difference in BIS level between adults and children during target-controlled infusion of propofol; Recovery from anesthesia in patients undergoing abdominal surgery： a comparison of sevoflurane and isoflurane     

Anesthesia

Effects of hydroxyethyl starch on leukocyte activation and vascular permeability in endotoxic rats; Effects of adenosine preconditioning on expression of myocardial TNF-α mRNA and ICAM-1 mRNA in patients undergoing off-pump coronary artery bypass graft operation; The changes in cognitive function and beta amyloid protein after partial hepatectomy in rats; Relationship between tolblike receptor 2 on polymorphonuclear neutrophil and postoperative systemic inflammatory response syndrome in patients undergoing orthotopic liver transplantation; Effect of microglia inhibition on GABAs receptor expression in the spinal cord in a rat model of neuropathic pain……     

Anesthesia

Effects of DO2-directed hemodynamic management on pulmonary function in to course of anaesthesia of liver transplantation; Rectal midazolam, atropine and ketamine as premedication for infants and young children; Supraclavicular subclavian venous catheterization through the insertion point medial to the middle of clavicle in infants; Effect of acute normovolemic hemodilution on context-sensitive half-time for propofol given by target controlled infusion during hip joint replacement; Effect of acute hypervolemic hemodilution on pharmacokinetics of propofol in patients undergoing total hip replacement; Influence of leukocyte filtration on systemic inflammatory response to cardiopulmonary bypass in dogs;Effect of urapidil on L-type calcium current in rat ventricular myocytes; Changes in systemic and pulmonary hemodynamics in patients with liver cirrhosis and portopulmonary hypertension during liver transplantation;……