单侧腰-硬联合麻醉用于高龄患者髋关节手术的效果

【摘要】 目的 探讨80岁以上高龄患者髋关节置换手术采用单侧腰硬联合麻醉的临床效果。 方法 我院2009年至2011年择期行髋关节置换手术病例130例,年龄在80~96岁,ASA Ⅱ~Ⅲ级。将130例随机分为对照组和观察组,每组各65例,观察组于L3-L4穿刺采用单侧腰硬联合麻醉;对照组于L2-L3穿刺采用硬膜外麻醉。两组患者一般资料无明显差异,具有可比性。观察两组麻醉效果。 结果 观察组患者在麻醉起效时间和麻醉阻滞完善时间明显较对照组快,(P<0.05)。两组患者麻醉前后心率无明显变化,对照组的收缩压、舒张压、平均动脉压麻醉后与术前比较波动较大(P<0.05)。两组患者麻醉效果比较,观察组麻醉效果好于对照组。 结论 单侧腰硬联合麻醉具有起效快、镇痛和肌松效果好、麻醉平面可控性强、呼吸循环影响小等优点,可安全有效地用于高龄患者的手术麻醉。

Effect of unilateral combined spinal-epidural anesthesia in elderly patients with hip joint operation

Objective To explore the clinical effect of hip-joint replacement surgery in 80 years or older patients under unilateral combined spinal-epidural anesthesia. Methods A total of 130 cases in our hospital from 2009 to 2011 undergoing hip joint operation , at the age of 80-96, ASA Ⅱ-Ⅲ,.were randomly divided into control group （n=65） and observation group （n=65）. In the observation group,.L3-L4 puncture with unilateral combined spinal-epidural anesthesia were applied ,.and L2 -L3 puncture using epidural anesthesia was applied in the control group. .Anesthetic effects of the two groups were observed..Results The onset time and total-block time of anesthesia in the observation group was significantly faster than that in the control group （P0.05）. The heart rate in two groups of patients before and after anesthesia had no significant change. .The systolic pressure ,.diastolic pressure,.mean arterial pressure after anesthesia in controls fluctuated much more than that in control group. （P 0.05）..The anesthetic effect in the observation group was better than control group. Conclusion Unilateral combined spinal-epidural anesthesia has the advantages of quick effect , analgesia and muscle relaxation effect. With little respiratory and circulatory side effect , the methods can be used safely and effectively in the anesthesia for elderly patients.