小剂量轻比重腰麻―硬膜外联合麻醉在老年下肢骨折手术中应用效果分析.docVIP

小剂量轻比重腰麻―硬膜外联合麻醉在老年下肢骨折手术中应用效果分析 　　doi：10.3969/j.issn.1007-614x.2014.20.55 　　摘 要 目的：探讨分析小剂量轻比重腰麻-硬膜外的联合麻醉（CSEA）用于老年患者下肢多种骨折手术中应用效果。方法：收治下肢骨折老年患者62例，随机分为对照组和观察组各31例。对照组采用麻醉方法为连续硬膜外麻醉，观察组采用方法为小剂量轻比重CSEA方法，观察麻醉后患者SBP、DBP及HR的变化，对比分析所用手术时间以及麻醉效果等。结果：患者麻醉后不同时间点的SBP、DBP及HR较麻醉前略有下降，但仅SBP的数值变化差异有统计学意义（P0.05）。观察组麻醉起效时间（5.5±2.6）分钟和麻药用量（4.1±2.8） ml，分别少于对照组的（12.2±3.5）分钟、（12.3±3.5） ml，两组差异有统计学意义（P0.05）。结论：腰麻-硬膜外联合麻醉作用时间便于调控，术后镇痛效果确切，小剂量轻比重的联合麻醉可以安全地应用于老年人下肢骨折手术的麻醉。 　　关键词 小剂量轻比重 腰麻-硬膜外联合麻醉 老年人 下肢骨折 　　Application effect analysis of small dose and hypobaric combined spinal epidural anesthesia in the operation of lower limb fractures in the elderly 　　Zhang Feng 　　Department of Anesthesiology，Zhengzhou Ruilong Hospital（Xingyang City，Henan） 450199 　　Abstract Objective：To explore the application effect of small dose and hypobaric combined spinal epidural anesthesia in the operation of lower limb fractures in the elderly.Methods：62 elderly cases with lower extremity fracture were selected.They were randomly divided into the control group and the observation group with 31 cases in each.The control group using the method of anesthesia was continuous epidural anesthesia.The observation group using the method of anesthesia was the CSEA method（small dose light specific gravity）.We observed the changes in patients with SBP，DBP and HR after anesthesia，and analyzed the operation time and the anesthesia effect and so on.Results：After anesthesia，SBP， DBP and HR at different time points was slightly decreased than before anesthesia，but the difference was statistically significant only in the value of SBP（P0.05）.In the observation group，the onset time of anesthesia was （5.5±2.6）minutes，and anesthetic dosage was （4.1±2.8） ml.They were less than that in the control group with （12.2±3.5）minutes，（12.3±3.5） ml respectively.The differences were statistically significant（P0.05）.Conclusion：For combined spinal epidural anesthesia，the action time is easy to control.Postoperative analgesic effect is ex