首页|连续硬膜外麻醉复合收肌管阻滞应用于老年膝关节置换手术的临床效果观察

连续硬膜外麻醉复合收肌管阻滞应用于老年膝关节置换手术的临床效果观察

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目的:探究连续硬膜外麻醉复合收肌管阻滞用于老年膝关节置换术的有效性及安全性。方法:选取 2022 年 5月—2023 年 12 月蚌埠医科大学第一附属医院收治的 60 例行膝关节置换术老年患者作为研究对象,根据随机数表法分为实验组和对照组,每组各 30 例。实验组实施连续硬膜外麻醉复合收肌管阻滞治疗,对照组实施连续硬膜外麻醉治疗,比较两组术后 6 h、12 h、24 h、48 h视觉模拟疼痛(VAS)评分,术后 24 h、48 h下肢肌力情况及可行走距离以及术后 2 d内低血压、恶心呕吐、嗜睡等并发症发生率。结果:实验组在术后各时间点疼痛评分均低于对照组,差异有统计学意义(P<0。05);术后 24 h、48 h,两组下肢肌力比较,差异无统计学意义(P>0。05),术后 24 h、48 h,实验组行走距离大于对照组,差异有统计学意义(P<0。05);两组术后并发症的发生率比较,差异无统计学意义(P>0。05)。结论:连续硬膜外麻醉复合收肌管阻滞在老年患者膝关节置换术中应用效果显著,不仅为术后提供良好的镇痛效果,且有利于患者早期下床活动。
Clinical Observation of Continuous Epidural Anesthesia Combined with Adductor Block in Elderly Patients Undergoing Knee Replacement
Objective:To investigate the efficacy and safety of continuous epidural anesthesia combined with adductor block in elderly patients undergoing knee replacement.Method:60 elderly patients undergoing knee replacement in the First Affiliated hospital of Bengbu Medical University from May 2022 to December 2023 were selected as the study objects and randomly divided into experimental group and control group,with 30 cases in each group.The experimental group was treated with continuous epidural anesthesia combined with adductor block,while the control group was treated with continuous epidural anesthesia.Visual analogue pain(VAS)scores 6 h,12 h,24 h and 48 h after surgery,lower limb muscle strength and walking distance 24 h and 48 h after surgery,and incidence of complications such as hypotension,nausea,vomiting and drowsiness within 2 days after surgery were compared between the two groups.Result:The pain scores of the experimental group were lower than those of the control group at each time point after operation,and the difference was statistically significant(P<0.05).There was no significant difference in the comparison of muscle strength of lower limbs between the two groups 24 h and 48 h after operation(P>0.05).The walking distance of the experimental group was greater than that of the control group 24 h and 48 h after operation,and the difference was statistically significant(P<0.05).There was no significant difference in incidence of postoperative complications between the two groups(P>0.05).Conclusion:The application of epidural anesthesia combined with adductor block in elderly patients with knee replacement,which not only provides postoperative analgesic,but also helps patient to get out of bed early.

Continuous epidural anesthesiaAdductor blockKnee replacement in the elderlyPostoperative analgesia

黄辉

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蚌埠医科大学第一附属医院 安徽 蚌埠 233000

连续硬膜外麻醉 收肌管阻滞 老年膝关节置换术 术后镇痛

2024

中外医学研究
中国医院管理杂志社

中外医学研究

影响因子:1.149
ISSN:1674-6805
年,卷(期):2024.22(36)