全身麻醉联合硬膜外麻醉在老年患者手术中的应用

目的 探讨全身麻醉联合硬膜外麻醉在老年患者手术中的应用效果。方法 将河北省涞水县医院2015年8月至12月收治的100例老年手术患者随机分为观察组和对照组,对照组采用全身麻醉,观察组采用全身麻醉联合硬膜外麻醉,比较观察组和对照组患者术中的血流动力学情况、术后恢复时间、苏醒期情况、认知障碍情况以及安全性。结果 观察组插管后 3 min、手术操作时、拔管时的血压和心率均低于对照组,苏醒、拔管及应答时间均短于对照组,差异有统计学意义(P<0.05)。观察组苏醒期疼痛率低于对照组,术后12 h、24 h的MMSE评分低于对照组,差异有统计学意义(P<0.05)。观察组和对照组的不良反应无统计学意义(χ²=0.796,P>0.05)。结论 全身麻醉联合硬膜外麻醉能够维持老年手术患者生命体征的稳定,提高苏醒质量,减少术后认知障碍的发生。

Application of general anesthesia combined with epidural anesthesia in elderly patients with surgery

Objective To investigate the effect of general anesthesia combined with epidural anesthesia in elderly patients with surgery. Methods 100 cases of elderly patients with surgery in our hospital from August to December 2015 were randomly divided into the observation group and the control group, the control group was given general anesthesia, the observation group was given epidural anesthesia, the hemodynamics and postoperative recovery time, recovery period, cognitive avoidance obstacle and security of two groups were compared. Results The results indicated that the blood pressure and heart rate at 3 min after intubation, surgical operation and extubation in the observation group were lower than that in the control group, wake up, extubation and response time were shorter than that in the control group, the difference was statistically significant(P<0.05). The rate of pain in observation group were lower than that in the control group, the MMSE score in 24 h and 12 h after operation were lower than that in control group, and the difference were statistically significant(P<0.05). The adverse reactions between the two groups were not statistically significant(χ²=0.796,P>0.05). Conclusion General anesthesia combined with epidural anesthesia can maintain the stability of vital signs, improve the awakening quality and reduce the incidence of postoperative cognitive impairment.