摘要
目的探讨腰麻在全膝关节置换术中的临床应用及效果。方法回顾性分析2010年1月至2017年12月开展全膝关节置换术的患者46例的资料,其中全麻组23例,腰麻组23例,分别行全身麻醉及腰麻,观察两组患者麻醉效果、术中出血量、输液量、手术时间、躁动及术后不良反应发生情况。结果腰麻组麻醉总有效率明显优于全麻组(100%vs 73. 91%,P <0. 05)。两组患者手术时间、术中输液量及术中出血量差异均无统计学意义(P均>0. 05)。两组患者手术均成功完成。术中腰麻组躁动发生率低于全麻组(0 vs 26. 09%,P <0. 05)。腰麻组患者出现1例恶心呕吐,全麻组有2例出现头昏及视物模糊,4例出现呕吐,2例出现下肢深静脉血栓,腰麻组不良反应发生率低于全麻组(4. 35%vs 34. 78%,P <0. 05)。结论腰麻患者术中可保持清醒,麻醉效果确切,不良反应发生率低,在排除腰麻禁忌前提下可作为全膝关节置换术的常规麻醉方式之一。
Objective To explore and compare the clinical application and effects of lumbar anesthesia and general anesthesia in total knee arthroplasty. Methods Forty-six patients undergoing total knee arthroplasty from January 2010 to December 2017 were retrospectively analyzed and divided into general anesthesia group and lumbar anesthesia group（n =23,each）. The anesthetic effect,intraoperative blood loss,infusion volume,operation time,restlessness and postoperative adverse reactions were observed and compared. Results The total effective rate of anesthesia in lumbar anesthesia group was significantly better than that in general anesthesia group（100% vs 73. 91%,P〈0. 05）. There were no significant differences in operative time,intraoperative transfusion volume and intraoperative blood loss between two groups（all P〈0. 05）. The surgery was successfully completed in all patients. During the operation,the incidence of restlessness in lumbar anesthesia group was significantly lower than that in general anesthesia group（0 vs 34. 78%,P〈0. 05）. There were 1 case of nausea and vomiting in lumbar anesthesia group and 2 cases of dizziness and blurred vision,4 cases of vomiting,2 cases of deep vein thrombosis in the lower extremity in general anesthesia group. The incidence of adverse reactions in lumbar anesthesia group was obviously lower than that in general anesthesia group（4. 35% vs 34. 78%,P〈0. 05）. Conclusions Patients with lumbar anesthesia can remain awake during total knee arthroplasty,and the anesthesia effect is definite with lower incidence of postoperative adverse reactions. Under the premise of excluding the contraindication of lumbar anesthesia,it can be used as one of the conventional anesthesia methods for total knee replacement.
作者
曾嵘
顾仕贤
常胜和
王庆宝
王国品
顾建平
ZENG Rong;GU Shi-xian;CHANG Sheng-he;WANG Qing-bao;WANG Guo-pin;GU Jian-ping(Department of Anesthesiology,Nanjing Jiangbei People＇s Hospital Affiliated to Nantong University,Nanjing,Jiangsu 210045,China)
出处
《中国临床研究》
CAS
2018年第11期1516-1518,共3页
Chinese Journal of Clinical Research
基金
国家自然科学基金(81541061)
南京市科委科技发展基金(YKK16266)
关键词
膝关节置换术
全身麻醉
腰麻
麻醉效果
Knee arthroplasty
General anesthesia
Lumbar anesthesia
Anesthetic effect
