全麻与硬膜外阻滞麻醉对下肢骨折手术患者术后镇痛效果的影响.docx

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全麻与硬膜外阻滞麻醉对下肢骨折手术患者术后镇痛效果的影响

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【摘要】目的：比较全身麻醉与硬膜外阻滞麻醉对下肢骨折手术患者术后镇痛效果。方法：选取于我院行下肢骨折手术的患者98例，随机分为对照组和观察组。两组进行相同的术前准备；对照组采用全身麻醉进行手术；观察组采用硬膜外阻滞麻醉进行手术。两组均于术后48h后拔除镇痛泵，观察组同时拔除硬膜外导管。记录两组患者术后不同时间点的VAS评分，以及术前及术后的MMSE评分，比较两种麻醉方式的术后镇痛效果及安全性。结果：随着术后镇痛时间的延长，VAS评分逐渐减小，术后48h达到最小值；两组术后不同时间点的VAS评分比较具有统计学差异（P0.05），观察组疼痛程度明显小于对照组；两组患者术前MMSE评分没有明显差异（P0.05），随着术后时间的延长，两组MMSE评分均有所回升，且观察组术后不同时间点MMSE评分高于对照组，差异具有统计学意义（P0.05）。结论：在下肢骨折手术中采用硬膜外阻滞麻醉，患者术后镇痛效果更好，对神经系统也能起到有效的保护作用，具有更好的安全性。

【关键词】全身麻醉；硬膜外阻滞麻醉；下肢骨折；疼痛

R683.42A2095-1752（2017）18-0220-02

EffectofGeneralanesthesiaandEpiduralanesthesiaonPostoperativeanalgesiainpatientswithLowerLimbFracture

YangYan.

DepartmentofAnesthesiology,TraditionalChineseMedicineHospitalofLuzhouCity,SichuanLuzhou646000,China

【Abstract】ObjectiveTocomparetheeffectofgeneralanesthesiaandepiduralanesthesiaonpostoperativeanalgesiainpatientswithlowerlimbfracture.MethodsChoose98casesoflowerlimbfracturesurgeryinourhospital,andrandomlypidedintotwogroups.Thetwogroupswerealldislodgetheanalgesiapumpinpostoperative48h,theobservationgroupwasextractedtheepiduralcatheteratthesametime.RecordtheVASscoresoftwogroupsatdifferenttimepoints,preoperativeandpostoperativeMMSEscores,comparedthepostoperativeanalgesiaandsafetyoftwokindsanesthesia.ResultsWiththeprolongthedurationofanalgesiaafteroperation,TheVASscoredecreasedgradually,after48hreachestheminimumvalue;atdifferenttimepoints,thetwogroupswithVASscorewerestatisticallydifference(P0.05),paindegreeofobservationgroupwassignificantlylessthanthecontrolgroup;Beforeoperation,twogroupsofpatientswithMMSEscoreshadnosignificantdifference(P0.05),Withtheextensionofpostoperativetime,thetwogroupsofMMSEscorewerepickedup,andtheobservationgroupMMSEscorewashigherthanthecontrolgroupatdifferenttimepoints,thedifferencewasstatisticallysignificant(P0.05).ConclusionInthelowerlimbfracturesurgerywithepiduralanesthesia,thepostoperativeanalgesiaeffectisbetterthanGeneralanesthesia,itcanplayaneffectiveprotectiveeffectonthenervoussystem,thesecurityisfine.

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