Zhong Huanhui, Wang Yongdong, Wang Yiqun, Wang Baiyun
Department of Anesthesiology, Affiliated Nanhua Hospital, University of South China, Hengyang, Hunan 421002, P.R. China.
Exp Ther Med. 2019 Jun;17(6):4421-4426. doi: 10.3892/etm.2019.7465. Epub 2019 Apr 3.
Effect and clinical value in general anesthesia and combined spinal-epidural anesthesia in elderly patients undergoing hip arthroplasty were compared. One hundred and six patients with hip arthroplasty in the Affiliated Nanhua Hospital, University of South China from May 2013 to July 2015 were selected as the research subjects, including 50 patients in the study group who received combined spinal-epidural anesthesia by ondansetron hydrochloride tablets combined with spinal-epidural puncture kit, and 56 patients in the control group who received general anesthesia by fast-induced endotracheal intubation. Retrospective analysis was performed in terms of anesthesia effect, complete block time, anesthesia onset time, hemodynamic parameters at different time points before and after the surgery, and adverse reactions after the surgery. The study group had a statistically shorter onset time and a statistically shorter complete block time than the control group (P<0.05). No significant difference in the heart rate, systolic blood pressure or diastolic blood pressure before the surgery in the two groups was shown (P>0.05); the heart rate, systolic blood pressure, and diastolic blood pressure in the study group 20 min after the start of the operation and 15 min before the end of the operation were significantly higher those in the control group (P<0.05); the adverse reactions such as venous thrombosis, pulmonary infection, and nausea and vomiting in the study group were fewer than those in the control group (P<0.05). For elderly patients with fracture surgery, both the general anesthesia and the combined spinal-epidural anesthesia can maintain a good anesthesia effect, but the combined spinal-epidural anesthesia can shorten the onset time and has less impact on the patient's hemodynamic parameters and less incidence of complications, thus worthy of clinical promotion.
比较全身麻醉与腰硬联合麻醉在老年髋关节置换术患者中的效果及临床价值。选取2013年5月至2015年7月在南华大学附属南华医院行髋关节置换术的106例患者作为研究对象，其中研究组50例患者采用盐酸昂丹司琼片联合腰硬穿刺套件行腰硬联合麻醉，对照组56例患者采用快速诱导气管插管全身麻醉。对麻醉效果、完全阻滞时间、麻醉起效时间、手术前后不同时间点的血流动力学参数及术后不良反应进行回顾性分析。研究组的起效时间和完全阻滞时间均显著短于对照组（P<0.05）。两组术前心率、收缩压及舒张压比较，差异无统计学意义（P>0.05）；手术开始20 min及手术结束前15 min时，研究组心率、收缩压及舒张压均显著高于对照组（P<0.05）；研究组静脉血栓、肺部感染及恶心呕吐等不良反应少于对照组（P<0.05）。对于老年骨折手术患者，全身麻醉和腰硬联合麻醉均能维持良好的麻醉效果，但腰硬联合麻醉起效时间短，对患者血流动力学参数影响小，并发症发生率低，值得临床推广。
