两种麻醉方法对双膝关节置换术患者麻醉恢复期的影响

发布时间：2019-03-06 20:10

【摘要】：目的对比分析单纯全麻(GA)和全麻联合双侧股神经阻滞(FGA)两种麻醉方式对双膝关节置换术患者麻醉恢复期的影响。方法纳入2014年1~12月于解放军总医院行双膝关节置换手术的患者,通过查阅电子病历、麻醉及麻醉恢复室记录单,统计GA组和FGA组患者的一般情况,包括性别、年龄、BMI,术前及术后心率(HR)、血压(BP)、脉搏氧饱和度(Sp O2),麻醉时间、手术时间、应用止血带时间、拔管时间,失血量及两组送恢复室患者比例和恢复室停留时间等。结果 205例患者纳入研究,两组患者一般情况差异无统计学意义。其中GA组150例,有77例(51.3%)带管送恢复室,1例(0.7%)带管回病房,1例带储氧面罩回病房;FGA组55例,有19例(34.5%)带管送恢复室,无带管回病房病例。FGA组拔管时间[(13.8±16.7)min vs.(21.3±17.4)min]和恢复室停留时间[(52.1±16.9)min vs.(63.6±30.1)min]较GA组显著减少,差异有统计学意义(P0.01)。结论全麻联合双侧股神经阻滞麻醉可以降低术后带管送恢复室的需求,促进早期拔管,缩短麻醉恢复时间和恢复室停留时间,加快手术间及恢复室的周转。
[Abstract]:Objective to compare the effects of general anesthesia (GA) and general anesthesia combined with bilateral femoral nerve block (FGA) on the recovery period of anesthesia in patients with bilateral knee arthroplasty. Methods from January to December 2014, the patients who underwent double knee arthroplasty in PLA General Hospital were included. The general situation of patients in GA group and FGA group, including sex, age, BMI, were recorded by means of electronic medical records, anaesthesia and anesthetic recovery room records. Preoperative and postoperative heart rate, (HR), blood pressure, (BP), pulse oxygen saturation (Sp O 2), anesthesia time, operation time, application time of tourniquet, extubation time, blood loss, the proportion of patients sent to the recovery room and the stay time of the recovery room in the two groups. Results 205 patients were included in the study. There was no significant difference between the two groups in general. In the GA group, 77 cases (51.3%) were sent to the recovery room, 1 case (0.7%) to the ward, and 1 case to the ward with oxygen storage mask. Among 55 cases in FGA group, 19 cases (34.5%) were sent to the recovery room with tube. The time of extubation [(13.8 卤16.7) min vs. (21.3 卤17.4) min] and the stay time of recovery room [(52.1 卤16.9) min vs. (63.6 卤30.1) min] in FGA group were significantly lower than those in GA group. The difference was statistically significant (P0.01). Conclusion General anesthesia combined with bilateral femoral nerve block anesthesia can reduce the need for postoperative delivery of tube to the recovery room, promote early extubation, shorten the recovery time and stay time of the recovery room, and accelerate the turnover of the operation room and the recovery room.
【作者单位】：解放军总医院麻醉手术中心;
【分类号】：R614

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