利多卡因辅助局部麻醉在老年外伤性颈胸段脊髓损伤减压手术的应用

目的：探讨利多卡因辅助局部麻醉在老年外伤性颈胸段脊髓损伤减压手术的应用方法与效果。方法：采用前瞻性研究方法，选择2013年2月至2015年12月在我院进行诊治的外伤性颈胸段脊髓损伤老年患者78例，根据入院顺序分为观察组与对照组各39例，两组都给予减压手术治疗，对照组选择全身麻醉，观察组选择利多卡因辅助局部麻醉，观察两组预后情况。结果：两组患者在麻醉前后的收缩压、舒张压、心率未出现明显变化，对比差异均无统计学意义（P>0.05）。观察组术中神经损伤、术后呼吸道不适等并发症发生率与住院时间分别为2.6%和（7.11±0.45d），而对照组分别为23.1%和（9.33±0.51d），观察组的两项指标明显低于对照组（P<0.05）。术后观察组与对照组的麻醉满意度分别为100.0%和84.6%，观察组明显高于对照组（P<0.05）。观察组与对照组术后3个月的JOA评分分别为（12.94±2.84）分和（10.49±2.44）分，都明显高于术前的（5.37±1.49）分和（5.42±1.33）分，组间对比差异也有统计学意义（P<0.05）。结论：利多卡因辅助局部麻醉在老年外伤性颈胸段脊髓损伤减压手术的应用具有较好的安全性，能提高麻醉效果，减少并发症的发生，缩短住院时间，促进颈椎功能的恢复。

Application of Lidocaine-Assisted Local Anesthesia in Decompression Surgery in Elderly Patients with Traumatic Cervical Thoracic Spinal Cord Injury

Objective: To investigate the application and effect of lidocaine-assisted local anesthesia in decompression surgery in elderly patients with traumatic cervical thoracic spinal cord injury.Methods: A prospective study method was used. 78 cases of elderly patients with traumatic cervical thoracic spinal cord injury for diagnosis and treatment in our hospital from February 2013 to December 2015 were selected. The patients were equally divided into observation group and control group with 39 cases in each according to the order of admission. The two groups were given decompression surgery for the treatment, the control group was selected for general anesthesia and the observation group as given lidocaine for local anesthesia. The prognosis in the two groups was observed.Results: There was no significant change in systolic pressure, diastolic pressure and heart rate of the two groups before and after anesthesia (P>0.05). In the observation group, the incidence of complications such as intraoperative nerve injury and postoperative respiratory discomfort and hospitalization time were 2.6% and 7.11±0.45d, respectively, while those in the control group were 23.1% and 9.33±0.51d, indicating that the 2 indicators of the observation group were significantly lower than those of control group (P<0.05). The anesthetic satisfaction of the observation group and the control group were 100% and 84.6% respectively, indicating that the satisfaction of the observation group was significantly higher than that of the control group (P <0.05). The 3-month post operation JOA scores of the observation group and control group were 12.94±2.84 points and 2.44±10.49 points respectively, which were significantly higher than the preoperative JOA scores of 5.37±1.49 points and 5.42±1.33 points respectively. The difference between the two groups was also statistically significant (P<0.05).Conclusion: Lidocaine-assisted local anesthesia in decompression operation in elderly patients with traumatic cervical thoracic spinal cord injury is fairly safe and can improve the anesthetic effect, reduce complications, shorten the hospitalization time and promote the recovery of the function of the cervical spine.