全麻复合腰丛―坐骨神经阻滞在老年髋关节置换术中的应用价值分析.docVIP

全麻复合腰丛―坐骨神经阻滞在老年髋关节置换术中的应用价值分析 　　【摘要】目的：探究全麻复合腰丛阻滞在老年髋关节置换术中的应用价值。方法：选取2013年1月～2015年1月我院诊治的72例老年全髋关节置换术患者，随机分成对照组和实验组，各36例，分别采用全身麻醉、全身麻醉复合腰丛阻滞，比较两组患者麻醉药物用量、插管前后HR、SBP、MAP等变化，同时分析两组患者术后清醒、拔管、躁动、疼痛及麻醉相关并发症发生情况。结果：实验组患者全麻药物诱导量及维持量均明显小于对照组患者，且有显著的统计学差异（P0.05），对照组患者插管后5min、30min、60min、手术结束及拔管后5min HR、SBP、MAP均明显升高，且有显著的统计学差异（P0.05）；实验组患者术后30min内清醒、拔管人数均明显多于对照组，躁动、疼痛人数均明显少于对照组，均有显著的统计学差异（P0.05）。结论：较全身麻醉，全麻复合腰丛阻滞能维持患者机体的平稳，减少术后不适反应，更适合老年髋关节置换术。 　　【关键词】全身麻醉；腰丛阻滞麻醉；老年患者；髋关节置换术 　　[Abstract]： Objectives： To investigate the application value of anesthesia combined lumbar plexus block in total hip arthroplasty in elderly patients. Methods： 72 cases of elderly patients undergoing total hip arthroplasty from January 2012 to January 2014 were randomly divided into control and experimental groups， each of 36 cases， respectively. Patients of control group undergo general anesthesia while experimental group undergo general anesthesia combined lumbar plexus block. Observe the difference of the amount of narcotic drugs， intubation around HR， SBP， MAP and analysis postoperative awake extubation， restlessness， pain and anesthesia-related complications between these two groups. Results： The drug-induced anesthesia and maintain dosage of experimental group was significantly less than the control group （P 0.05）.There was no difference of HR， SBP， MAP intubated after 5min， 30min， 60min or the end of surgery and extubation compared with baseline values before intubation in experimental group，while the control group higher （P 0.05）； sober 30min， patients in the experimental group， the number extubation was significantly more than the control group， the restlessness， the number of pain were significantly less than the control group （P 0.05）. Conclusion： Compared with general anesthesia， anesthesia combined lumbar plexus block maintain patient body smooth， reduce postoperative discomfort. It is more suitable for elderly hip arthroplasty. 　　[Key word]： general anesthesia； lumbar plexus block；