CAJ | 학술논문

目的：观察采用不同麻醉方式对老年骨科患者手术后的镇痛效果。方法选取2010年1月至2013年12月在该院收治的需行下肢骨科手术治疗的老年患者180例，按照麻醉方式不同分成三组，全身麻醉组（G A组）、腰‐硬联合麻醉组（CSEA组）和外周神经阻滞麻醉组（NBA组），镇痛方法均采用静脉镇痛。术后评价患者多个时点的视觉模拟（VAS）评分、不良反应发生率和镇痛效果满意度。结果 T1～ T4时点，三组间 VAS评分差异有统计学意义（P＜0．05），多重比较结果显示NBA组的VAS评分明显低于其余两组（P＝0．0167）；而在T5和T6时点，三组间差异无统计学意义（P＞0．05）；三组患者术后并发症发生率之间的差异有统计学意义（P＜0．05），多重比较结果显示NBA组的并发症发生率明显小于其他两组（P＝0．0167）；三组患者对镇痛效果满意度之间的差异也有统计学意义（P＜0．05），多重比较也显示NBA组的镇痛效果满意度优于其他两组（P＝0．0167）。结论采用外周神经组织麻醉进行骨科手术的老年患者术后采用静脉镇痛的效果显著。
목적：관찰채용불동마취방식대노년골과환자수술후적진통효과。방법선취2010년1월지2013년12월재해원수치적수행하지골과수술치료적노년환자180례，안조마취방식불동분성삼조，전신마취조（G A조）、요‐경연합마취조（CSEA조）화외주신경조체마취조（NBA조），진통방법균채용정맥진통。술후평개환자다개시점적시각모의（VAS）평분、불량반응발생솔화진통효과만의도。결과 T1～ T4시점，삼조간 VAS평분차이유통계학의의（P＜0．05），다중비교결과현시NBA조적VAS평분명현저우기여량조（P＝0．0167）；이재T5화T6시점，삼조간차이무통계학의의（P＞0．05）；삼조환자술후병발증발생솔지간적차이유통계학의의（P＜0．05），다중비교결과현시NBA조적병발증발생솔명현소우기타량조（P＝0．0167）；삼조환자대진통효과만의도지간적차이야유통계학의의（P＜0．05），다중비교야현시NBA조적진통효과만의도우우기타량조（P＝0．0167）。결론채용외주신경조직마취진행골과수술적노년환자술후채용정맥진통적효과현저。
Objective To observe the postoperative analgesic effect of different anesthesia modes used in elder‐ly orthopedic patients .Methods 180 elderly patients needing lower extremity surgery in our hospital from January 2010 to December 2013 were selected and divided into three groups according to the different anesthesia modes ,the general anesthesia group(GA) ,combined spinal epidural anesthesia group(CSEA) and peripheral nerve block anes‐thesia group(NBA) .The intravenous analgesia was adopted .The visual analogue scale(VAS) scores at several time points ,incidence of adverse reactions and analgesic effect satisfaction were evaluated after operation .Results The VAS scores at T1 to T4 point had no statistically significant differences among the three groups (P<0 .05) ,the re‐sults of multiple comparisons showed that the VAS score in the NBA group was significantly lower than that in the other two groups(P=0 .016 7);while at T5 and T6 time points ,the difference among the three groups was not sta‐tistically significant (P>0 .05);the occurrence rate of complications had statistically significance differences among the three groups (P<0 .05) ,the results of multiple comparisons showed that the occurrence rate of complications in the NBA group was lower than that in the other two groups (P=0 .016 7);the analgesic effect satisfaction had sta‐tistical difference among the three groups (P<0 .05) ,the multiple comparison also showed that the analgesic effect satisfaction in the group NBA was better than that in the other two groups(P= 0 .016 7) .Conclusion Adopting postoperative intravenous analgesia in the patients with orthopedic operation by peripheral nerve block anesthesia has significant analgesic effect .