硬膜外麻醉及腰硬联合麻醉对高龄患者手术生命体征影响及安全性研究.docVIP

硬膜外麻醉及腰硬联合麻醉对高龄患者手术生命体征影响及安全性研究[摘要] 目的 探讨硬膜外麻醉与腰硬联合麻醉对高龄患者手术生命体征的影响，同时对安全性进行了对比。 方法 60例老年骨科手术患者随机为观察组与对照组，各30例，观察组采用腰硬联合麻醉，对照组采用硬膜外麻醉。测定并记录麻醉前后不同时间点的收缩压（SBP）、心率（HR）等血流动力学指标。观察两组麻醉前后的不良反应。 结果 观察组麻醉前后SBP与HR的变化都比较平稳，而对照组SBP有明显的下降，HR呈现波动，两组间相比差异有统计学意义（P ＜ 0.05）。观察组低血压、心动过缓、恶心、呕吐等不良反应明显少于对照组（P ＜ 0.05）。 结论 相对于硬膜外麻醉，腰硬联合麻醉应用于高龄手术患者能使血流动力学更加稳定，促进生命体征稳定，同时安全可靠，值得临床推广应用。 [关键词] 硬膜外麻醉；腰硬联合麻醉；老年人；血流动力学 [中图分类号] R614.2 [文献标识码] A [文章编号] 1673-7210（2012）07（c）-0094-02 Safety analysis and vital signs effects of epidural anesthesia and combined spinal-epidural anesthesia in elderly patients with hip arthroplasty ZHENG Kan Department of Anesthesiology, Beijing Shijingshan Hospital, Beijing 100043, China [Abstract] Objective To explore the safety and vital signs effects of epidural anesthesia and combined spinal-epidural anesthesia in elderly patients with hip arthroplasty. Methods 60 elderly patients with hip arthroplasty were randomly divided into the observation group and control group, the observation group were given combined spinal-epidural anesthesia, and the control group were only given epidural anesthesia. The systolic blood pressure (SBP), heart rate (HR) and other hemodynamic parameters were measured and recorded at different time before and after anesthesia. The adverse reactions of the two groups before and after anesthesia were observed. Results In the observation, the changes of SBP and HR before and after anesthesia were both relatively stable, while in the control group, SBP was significantly decreased, and HR fluctuated slightly, there were significant differences between the two groups (P ＜ 0.05). The hypotension, bradycardia, nausea, vomiting and other adverse reactions of the observation group were significantly less than the control group (P ＜ 0.05). Conclusion Compare to epidural anesthesia, combined spinal-epidural anesthesia used in patients with hip arthroplasty can make more stable hemodynamics, and promote vital signs stable, while is safe, reliabl