全身麻醉和硬膜外麻醉对老年全关节成形术患者早期认知功能及镇痛效果的影响

发布时间：2018-02-25 06:31

本文关键词： 全身麻醉硬膜外麻醉全关节成形术早期认知功能镇痛效果　出处：《中国老年学杂志》2017年20期 　论文类型：期刊论文

【摘要】：目的探讨全身麻醉和硬膜外麻醉对老年全关节成形术患者早期认知功能及镇痛效果的影响。方法择期行全关节成形术的老年患者80例,随机及分为全身麻醉组(n=40)和硬膜外麻醉组(n=40)两组,对两组临床疗效、简易智力状态检查量表(MMSE)评分、视觉模拟评分(VAS)、手术时间、麻醉时间、围术期输液量及输血量、下床锻炼时间、出院时间、感觉阻滞起效时间及恢复时间、运动阻滞起效时间及恢复时间、血流动力学、凝血功能指标及D-二聚体水平、术后并发症发生情况进行统计分析。结果硬膜外麻醉组麻醉优良率显著高于全身麻醉组,术后1 d VAS显著低于全身麻醉组,感觉阻滞起效时间、运动阻滞起效时间均显著短于全身麻醉组,感觉阻滞恢复时间、运动阻滞恢复时间均显著长于全身麻醉组,麻醉后6 h、术后1 d的D-二聚体水平均显著低于全身麻醉组,术后并发症发生率显著低于全身麻醉组(均P0.05)。结论全身麻醉和硬膜外麻醉对老年全关节成形术患者早期认知功能具有相似的影响,但后者较前者具有较好的镇痛效果。
[Abstract]:Objective to investigate the effect of general anesthesia and epidural anesthesia on early cognitive function and analgesic effect in elderly patients with total arthroplasty. The patients were randomly divided into general anesthesia group (n = 40) and epidural anesthesia group (n = 40). The clinical efficacy, MMSE score, visual analogue score (VASA), operation time, anesthetic time, transfusion volume and blood transfusion volume during perioperative period were evaluated. Exercise time, discharge time, onset time and recovery time of sensory block, onset time and recovery time of motor block, hemodynamics, coagulation function index and D-dimer level. Results the excellent and good rate of anesthesia in epidural anesthesia group was significantly higher than that in general anesthesia group, the VAS was significantly lower than that in general anesthesia group on 1 day after operation, and the onset time of sensory block was significantly lower than that in general anesthesia group. The onset time of motor block was significantly shorter than that of general anesthesia group, the recovery time of sensory block and motor block was significantly longer than that of general anesthesia group. The level of D-dimer at 6 hours after anesthesia and 1 day after operation was significantly lower than that in general anesthesia group. The incidence of postoperative complications was significantly lower in general anesthesia group than in general anesthesia group (P 0.05). Conclusion General anesthesia and epidural anesthesia have similar effects on the early cognitive function of elderly patients with total arthroplasty, but the latter has better analgesic effect than the former.
【作者单位】：内蒙古医科大学附属医院;
【基金】：内蒙古自治区自然基金项目(No.2016MS(LH)0820) 内蒙古自治区卫生和计划委员会项目(No.201303056)
【分类号】：R614

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