双侧股神经阻滞麻醉对老年双膝关节置换术患者血流动力学和苏醒时间的影响.docVIP

双侧股神经阻滞麻醉对老年双膝关节置换术患者血流动力学和苏醒时间的影响 　　[摘要] 目的 研究双侧骨神经阻滞麻醉对于老年双膝关节置换术患者的血流动力和苏醒时间的影响。方法 方便选取该院在2014年2月―2015年2月接收的60名即将进行双膝关节置换手术的患者，随机分为实验组和对照组，每组30例，其中对实验组患者实施双侧股神经阻滞麻醉，对照组在手术前实施全身麻醉，对两组患者在麻醉前、全麻诱导后、全麻诱导后即刻、手术开始、手术开始60 min、手术进行120 min、患者苏醒时HR、平均脉动压进行比较。对实验组和对照组患者的进行的手术时间以及止血所用的时间。术中使用的丙泊酚、芬太尼、瑞芬太尼的用量做出记录，对患者的苏醒时间、拔管时间做出详细的观察。结果 两组患者均在进行麻醉后顺利完成手术，实验组和对照组的手术时间差异无统计学意义，止血带应用的时间分别是（109.3±21.1） min、（122.5±21.6） min，两组的数据比较差异有统计学意义，实验组丙泊酚等药物用量明显低于对照组，患者的苏醒时间和拔管时间明显短于对照组。结论 双侧股神经阻滞麻醉同全身麻醉相比在老年双膝关节置换术中患者的具有明显的优势，可以在手术中减少对患者使用静脉镇静和镇痛药物，很好的稳定了血流动力学，缩短了患者手术后的苏醒时间 [关键词] 双侧骨神经；阻滞麻醉；双膝关节置换术；血流动力；苏醒时间 [中图分类号] R614 [文献标识码] A [文章编号] 1674-0742（2016）05（c）-0013-03 [Abstract] Objective To research the effect of bilateral femoral nerve block anesthesia on blood flow dynamics and relief time of elderly patients with double knee replacement surgery. Methods 60 cases of patients planning for double knee replacement surgery admitted in our hospital from February 2014 to February 2015 were selected and randomly divided into two groups with 30 cases in each， the experimental group implemented bilateral femoral nerve block anesthesia ， the control group implemented general anesthesia before operation， and the HR and mean fluctuating pressure of the two groups were compared before anesthesia ， after induction of general anesthesia， immediately after induction of general anesthesia， at the beginning of the operation， after 60min of operation， after 120min of operation and at the time of awakening of patients， and the operation time and hemostatic time were compared between the two groups， and the dosages of propofol， fentanyl and remifentanil in operation were recorded， and the awakening time and extubation time of patients were observed in detail. Results Both groups successfully finished operation after anesthesia， and there was no obvious difference in the operation time between the experimental group and the control group， and there was an obvious difference in the hemostatic time betw