腰硬联合麻醉在老年患者髋关节置换术中的应用

目的：观察腰硬联合麻醉在老年患者髋关节置换术中的麻醉效果及安全性。方法：择期施髋关节置换术的老年患者32例，随机分为腰硬联合（CSEA）组和连续硬膜外（EA）组，每组16例。两组均采用L2-3间隙穿刺，硬膜外腔穿刺成功后，CSEA组用25G腰麻针通过硬膜外穿刺针进入蛛网膜下隙，脑脊液回流通畅缓慢注入0．5％布比卡因1．5～2．0ml，然后放置硬膜外导管。EA组直接放置硬膜外导管，注入2％利多卡因5ml实验量，然后再注入1％罗哌卡因15－20ml。结果：与EA组比较，CSEA组麻醉效果优于EA组，CSEA组麻醉诱导时间短，硬膜外局麻药用量小，差异有显著性（P〈0．05）。结论：腰硬联合麻醉应用在老年患者髋关节置换术中更具优势。

An application of epidural anesthesia in elderly patients hip arthroplasty

Objective： To observe the efficacy and safety of anesthesia of epidural anesthesia in elderly patients hip arthroplasty. Methods： 32 cases of old patients who do the hip arthroplasty were divide randomly into CSEA group and EA group, e-ach group for 16 cases. After the two groups all succeed in L2-3 space puncture, epidural puncture, the CSEA group was treated through the epidural needle into the subarachnoid by 25G spinal needle, and then inject 1% ropivacaine for 15-20ml. Result： Compared with EA group, the effect of the CSEA group was better than that of EA group, the time of induction of anesthesia of the CSEA group is short, the dosages of durgs was little, the differe-nce was significant. Conclusion： Application of lumbar epidural anesthesia in elderly patients with hip arthroplasty had a better position.