CAJ | 학술논문

目的观察蛛网膜下腔麻醉联合硬膜外麻醉(腰硬联合麻醉)在高龄患者股骨头置换术中应用的安全性和有效性.方法选择2009年1月至2013年1月于陕西省榆林市第一医院骨科择期行人工股骨头置换术80例患者,采用随机数字表法随机分为腰硬联合麻醉组和硬膜外麻醉组,各40例.分别评定2组患者麻醉效果,记录术侧感觉阻滞起效时间和局部麻醉药物使用剂量,观察记录麻醉后各时点的平均动脉压和心率.结果腰硬联合麻醉组术侧感觉阻滞起效时间(45 ± 14)s明显短于硬膜外麻醉组[(261 ±57)s](P＜0.05),腰硬联合麻醉组椎管内左旋布比卡因使用总剂量为(10 ± 4) mg,明显少于硬膜外麻醉组[(86±24)mg](P＜0.05),腰硬联合麻醉组患者麻醉效果达到优的患者比例90.0％(36例)明显高于硬膜外麻醉组50.0％(20例)(P＜0.05).结论腰硬联合麻醉用于高龄患者人工股骨头置换术,起效迅速,镇痛完善,是一种较安全有效的麻醉方法.
목적 관찰주망막하강마취연합경막외마취(요경연합마취)재고령환자고골두치환술중응용적안전성화유효성.방법 선택2009년1월지2013년1월우합서성유림시제일의원골과택기행인공고골두치환술80례환자,채용수궤수자표법수궤분위요경연합마취조화경막외마취조,각40례.분별평정2조환자마취효과,기록술측감각조체기효시간화국부마취약물사용제량,관찰기록마취후각시점적평균동맥압화심솔.결과 요경연합마취조술측감각조체기효시간(45 ± 14)s명현단우경막외마취조[(261 ±57)s](P＜0.05),요경연합마취조추관내좌선포비잡인사용총제량위(10 ± 4) mg,명현소우경막외마취조[(86±24)mg](P＜0.05),요경연합마취조환자마취효과체도우적환자비례90.0％(36례)명현고우경막외마취조50.0％(20례)(P＜0.05).결론 요경연합마취용우고령환자인공고골두치환술,기효신속,진통완선,시일충교안전유효적마취방법.
Objective To observe the safety and effectiveness of combined spinal / epidural anesthesia (CSEA) in elderly patients undergoing femoral head replacement surgery.Methods Totally 80 patients who accepted femoral head replacement in Yan'an university school of medicine,second affiliated hospital orthopedic from January 2009 to January 2013.They were randomly divided into the CSEA group and epidural anesthesia group with 40 cases in each group.Anesthesia effect was evaluated in 2 groups.The initial acting time sensory block,local anesthesia drug dosage,mean arterial pressure and heart rate at each time point were recorded.Results The onset time of sensory block was significantly shorter in CSEA group (45 ± 14)s than in epidural anesthesia group (261 ± 57)s (P＜0.05).Levobupivacaine dosage was significantly lower in CSEA group (10 ±4)mg than that in epidural anesthesia group (86 ± 24) mg (P ＜ 0.05).Optimal anesthesia effect was achieved in 36 cases (90.0％) in CSEA group,significantly higher than that in anesthesia group(20 cases,50.0％) (P ＜ 0.05).Conclusion CSEA is a safe and effective anesthesia method.