老年下肢骨折手术中小剂量轻比重腰麻―硬膜外联合麻醉应用效果.docVIP

老年下肢骨折手术中小剂量轻比重腰麻―硬膜外联合麻醉应用效果 　　[摘要] 目的 探讨老年下肢骨折手术中小剂量轻比重腰麻-硬膜外联合麻醉（CSEA）的应用效果。方法 方便选取2012年5月―2016年7月该院收治的62例老年下肢骨折手术患者为研究对象，随机将入选病例均分为两组。实验组31例，患者术中行小剂量轻比重CSEA；对照组31例，患者术中行常规连续硬膜外麻醉。观察两组麻醉时间、麻醉效果及麻药用量。 结果 实验组患侧麻醉效果与对照组差异无统计学意义（P0.05）。实验组麻醉起效时间（22.4±6.1）s，麻醉完善时间（7.3±1.4）min，麻药用量（5.6±1.0）mg，健侧Bromage 2～3级显著减少，各项指标均显著优于对照组，差异有统计学意义（P0.05）。结论 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的应用效果理想，不仅起效迅速且麻药用量小、阻滞区域小，对降低老年麻醉手术风险具有积极意义。 　　[关键词] 老年；下肢骨折；小剂量轻比重；腰麻-硬膜外联合麻醉 　　[中图分类号] R614 [文献标识码] A [文章编号] 1674-0742（2017）04（c）-0129-03 　　[Abstract] Objective To discuss the application effect of small-dose and light specific gravity combined spinal-epidural anesthesia in lower limb fracture surgery in senile patients. Methods 62 cases of senile patients with lower limb fracture surgery admitted and treated in our hospital from May 2012 to July 2016 were convenient selected and randomly divided into two groups with 31 cases in each， the experimental group adopted the small-dose and light specific gravity CSEA， while the control group adopted the routine continuous epidural anesthesia， and the anesthesia time， effect and dose of the two groups were observed. Results The difference in the affected-side anesthesia effect between the two groups was not statistically significant（P0.05）， and the anesthesia onset time， anesthesia improved time and anesthesia usage in the experimental group were respectively （22.4±6.1）s， （7.3±1.4）min and （5.6±1.0）mg， and the contralateral Bromage 2～3 levels obviously decreased， and various indexes were obviously better than those in the control group， and the differences were statistically significant（P0.05）. Conclusion The application effect of small-dose and light specific gravity combined spinal-epidural anesthesia In lower limb fracture surgery in senile patients is ideal with rapid onset， small-dose anesthesia drugs and small blocking area， which is of positive significance to reducing the risks of senile anesthesia surgery. 　　[Key words] Senile； Lower limb fractu