膝关节镜手术中局部麻醉和脊椎麻醉的临床效果对比观察

目的比较局部麻醉和脊椎麻醉在膝关节镜手术中的临床应用效果,评价这两种麻醉方法的优缺点。方法选取2011—2013年间来该院进行膝关节镜手术的患者40例作为研究对象,将40例患者在年龄、性别、病况等方面无显著性差异的原则分成局麻组和脊椎组。对局麻组患者实施局部麻醉的方法,对脊椎组的患者实施脊椎麻醉的方法,手术结束后询问患者的术中疼痛情况、术后疼痛情况,密切观察患者术后出现的并发症。对患者进行VAS评分法评价患者对于手术过程的满意度。结果局麻组20例患者中3例患者感到手术中疼痛,5例感到手术后疼痛,3例出现术后并发症,脊椎组中有2例患者感到手术中疼痛,有2例患者出现术后疼痛,有9例出现了术后并发症。局麻组和脊椎组之间血压下降这一术后并发症差异（P〈0.05）。两组手术中、手术后感到疼痛的患者例数和其它术后并发症出现的患者例数间不存在显著性差异（P〉0.05）。结论在膝关节镜短小手术中建议采用局部麻醉,局部麻醉术后并发症少,在膝关节大手术中建议采用脊椎麻醉,其镇痛效果更为理想。

Comparative Observation on the Clinical Effects Between Local Anesthesia and Spinal Anesthesia in Knee Arthroscopic Operation

Objective To compare the clinical application effects between local anesthesia and spinal anesthesia in knee arthroscopic operation and evaluate the advantages and disadvantages of these two kinds of anesthesia methods. Methods 40 patients underwent knee arthroscopic operation in our hospital from 2011 to 2013 were selected as the subjects, and divided into the local anesthesia group and spinal anesthesia group according to the principle of no significant difference in age, gender and conditions of disease. Patients in the local anesthesia group were given local anesthesia, and patients in the spinal anesthesia group were given spinal anesthesia. After the operation, enquiring the patients＇ intraopertive and postoperative pain, observing the postoperative complications of the patients closely. VAS was used to evaluate the patients＇ satisfaction with the operation. Results Of the 20 patients in the local anesthesia group, 3 patients felt pain in operation, 5 patients felt pain after operation, postoperative complica-tions occurred in 3 cases, in the spinal anesthesia group, 2 patients felt pain in operation, 2 patients felt pain after operation, post-operative complications occurred in 9 cases. The difference in the postoperative complication of drop of blood pressure between the local anesthesia group and the spinal anesthesia group was statistically significant（P〈0.05）. The differences in the number with intraoperative and postoperative pain and that with complications except drop of blood pressure between the two groups were not statistically significant（P〉0.05）. Conclusion Local anesthesia is suggested to be used in the short and small knee operation such as knee arthroscopic operation, for it has less postoperative complications, and spinal anesthesia is recommended to be used in the big knee operation, because its analgesic effect is more ideal.