摘要
目的评价下肢神经阻滞复合喉罩全麻用于老年全髋置换术患者的优缺点。方法择期75岁以上高危老年全髋置换术患者72例随机均分为四组:A组(气管插管全麻),B组(下肢神经阻滞复合气管插管全麻),C组(喉罩全麻),D组(下肢神经阻滞复合喉罩全麻)。记录麻醉前(T1)、气管插管/置入喉罩时(T2)、骨膜剥离时(T3)、术毕(T4)、拔管/取出喉罩时(T5)的MAP、HR;记录清醒和拔出导管或喉罩时间、麻醉药用量及术中知晓情况。结果T2、T5时A、B组MAP、HR明显高于T1时(P<0.05);T3时A、C组MAP、HR明显高于T1(P<0.05)。术毕至拔气管导管或取出喉罩时间:A组(35.4士10.9)min,B组(21.3士6.8)min,C组(27.8士7.7)min,均明显长于D组的(11.2士4.3)min(P<0.01)。结论下肢神经阻滞复合喉罩全麻用于高危老年患者全髋置换术,患者血流动力学稳定,全麻药用量减少,恢复快。
Objective To evaluate the efficacy of general anesthesia（GA） with laryngeal mask airway（LMA） combined with lower extremity nerve block in the high-risk elderly undergoing total hip replacement. Methods A total of 72 people over 75 years old were divided randomly into four groups of A（GA with tracheal intubation）, B（GA with tracheal intubation and lower limb nerve block）, C （GA with LMA） and D（GA with LMA and lower extremity nerve block）. The changes of MAP and HR were recorded before anesthesia（T1 ）, at the time of tracheal intubation or LMA insertion（T2 ）, periosteal detaching（T3 ）, at the end of operation（T4 ） and extubation or LMA removal（T5 ）. The time of extuhation or LMA removal, awareness during anesthesia and anesthetic dosages were recorded. Results MAP and HR in groups of A and B were significantly higher at T2 and T5 than those at T1 （P〈0. 05）. MAP and HR in groups of A and C were significantly higher at Ta than those at T1 （P〈 0.05）. The time of extubation or LMA removal in group D [（11.2 ± 4. 3） min] was significantly shorter than （21.3±6.8） min in group B, （27. 8±7. 7） min in group C or （35.4±10. 9） rain in group A （P〈0. 01）. Conclusion GA with LMA combined with lower extremity never block could maintain the hemodynamics stable and reduce anesthetic dosage with rapid awakening in the high-risk elder patients undergoing THR.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2009年第9期749-751,共3页
Journal of Clinical Anesthesiology
关键词
下肢神经阻滞
喉罩
老年
Lower extremity never block； Laryngeal mask airway
Geriatrics
