布比卡因蛛网膜下腔-硬膜外对老年下肢骨折麻醉效果影响

发布时间：2018-04-27 02:12

本文选题：小剂量布比卡因蛛网膜下腔-硬膜外联合麻醉 + 下肢骨折　；参考：《中国卫生标准管理》2016年24期

【摘要】：目的分析采用小剂量布比卡因蛛网膜下腔-硬膜外联合麻醉的方式对老年下肢骨折患者循环功能的影响以及麻醉效果。方法遵循盲选原则在本院于2015年6月~2016年6月所收治的老年下肢骨折患者中选取80例作为研究对象,将其均分为观察组与对照组,每组各40例。观察组术中采用小剂量布比卡因蛛网膜下腔-硬膜外联合麻醉,对照组单纯给予连续硬膜外麻。比较两组患者麻醉效果以及循环功能的影响。结果治疗中,观察组麻醉药物使用量为(5.41±1.24)mg,对照组为(34.51±16.41)mg,观察组低于对照组,差异具有统计学意义(P0.05)。观察组麻醉起效用时为(46.24±10.39)s,而对照组为(345.14±54.84)s。观察组短于对照组,差异具有统计学意义(P0.05)。在改良Bromage评分上,观察组平均得分为(1.15±0.47)分,对照组为(2.84±0.94)分,观察组低于对照组,差异具有统计学意义(P0.05)。且麻醉后,观察组仅2例患者出现心动过缓,4例出现低血压,而对照组对应为8例、14例,差异具有统计学意义(P0.05)。结论与连续硬膜外麻相比,小剂量布比卡因蛛网膜下腔-硬膜外联合麻醉可有效减少术中对麻醉药的使用量,能将药物对循环功能的影响降至最低,帮助患者尽快恢复。
[Abstract]:Objective to analyze the effect of low dose bupivacaine combined subarachnoid and epidural anesthesia on circulatory function in elderly patients with lower extremity fracture. Methods according to the principle of blind selection, 80 elderly patients with lower extremity fracture were selected from June 2015 to June 2016. They were divided into observation group and control group with 40 cases in each group. The observation group was treated with low dose bupivacaine combined subarachnoid and epidural anesthesia, while the control group was given continuous epidural anesthesia. The effects of anesthesia and circulatory function were compared between the two groups. Results in the treatment, the dosage of narcotic drugs in the observation group was 5.41 卤1.24 mg / g, and that in the control group was 34.51 卤16.41 mg / g, which was significantly lower than that in the control group (P 0.05). The effect of anesthesia was 46.24 卤10.39 s in the observation group and 345.14 卤54.84 Ms in the control group. The observation group was shorter than the control group, and the difference was statistically significant (P 0.05). In the modified Bromage score, the average score of the observation group was 1.15 卤0.47, and that of the control group was 2.84 卤0.94). The observation group was lower than the control group, and the difference was statistically significant (P 0.05). After anesthesia, there were only 2 cases of bradycardia and 4 cases of hypotension in the observation group, compared with 8 cases (14 cases) in the control group. The difference was statistically significant (P 0.05). Conclusion compared with continuous epidural anesthesia, low dose bupivacaine combined subarachnoid and epidural anesthesia can effectively reduce the amount of anesthetics used during operation, minimize the influence of drugs on circulatory function, and help patients recover as soon as possible.
【作者单位】：福建省沙县医院麻醉科;
【分类号】：R614

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