|
| 羟考酮联合蛛网膜下腔阻滞在高龄患者股骨粗隆骨折手术中的应用 |
| Application of oxycodone combined subarachnoid block in the elderly patients with femoral trochanter fracture surgery |
| |
| DOI：10.12089/jca.2018.02.013 |
| 中文关键词: 羟考酮联合蛛网膜下腔阻滞 静-吸复合麻醉 高龄 股骨粗隆骨折 |
| 英文关键词: Oxycodone combined subarachnoid block Intravenous-inhalational anesthesia Old age Femoral trochanter fracture |
| 基金项目: |
|
| 摘要点击次数: 3119 |
| 全文下载次数: 1233 |
| 中文摘要: |
目的 比较高龄患者股骨粗隆骨折手术中羟考酮联合蛛网膜下腔阻滞与静-吸复合全麻的效果。方法 择期行股骨粗隆间骨折接受闭合复位股骨近端防旋髓内钉(PFNA)内固定术患者34例, 男13例, 女21例, 年龄76～92岁, ASA Ⅱ或Ⅲ级, 随机分为蛛网膜下腔阻滞联合静脉羟考酮组(O组)和静-吸复合全麻组(C组), 每组17例。麻醉前两组均未用术前药, 入室后O组静注羟考酮3～5 mg后, 蛛网膜下腔给予罗哌卡因12 mg；C组缓慢静注舒芬太尼0.2～0.3 μg/kg、顺式阿曲库铵0.15 mg/kg、依托咪酯0.1～0.2 mg/kg诱导, 术中泵注丙泊酚3～5 mg·kg-1·h-1、瑞芬太尼0.1～0.3 μg·kg-1·min-1, 吸入0.55%～2%七氟醚维持麻醉, 间断静脉注射顺式阿曲库铵0.05～0.10 mg/kg维持肌松。记录住院时间和麻醉相关并发症。结果 O组住院时间明显短于C组［(10.4±1.6)d vs (15.8±2.0)d, P＜0.05］。O组的术后恶心呕吐发生率明显低于C组［2例(11.8%) vs 9例(52.9%), P＜0.05］。结论 在高龄患者PFNA内固定手术中, 羟考酮联合蛛网膜下腔阻滞较静-吸复合麻醉提供更佳的效果。 |
| 英文摘要: |
| Objective To investigate the advantages and disadvantages of oxycodone combined subarachnoid block and intravenous-inhalational anesthesia in elderly patients with femoral trochanter fracturethe surgery. Methods Thirty-four patients undergoing elective surgery with closed reduction and Proximal femoral nail anti-rotation (PFNA) fixation, 13 males and 21 females, aged 76-92 years, ASA physical status Ⅱ or Ⅲ, were equally randomized into two groups (n=17 each): group O and group C. Patients in group O received oxycodone combined subarachnoid block. Patients in group C received intravenous-inhalational anesthesia. Patients in group C were not premeditated beforel entering the operation room. After entering the rooms group O was given oxycodone 3-5 mg i.v first, then given ropivacaine in subarachnoid space. All patients were induced with intravenous of sulfentanil 0.2-0.3 μg/kg, cisatracurium 0.15 mg/kg, etomidate 0.1-0.2 mg/kg slowly. Anesthesia was maintained by intravenous propofol 3-5 mg·kg-1·h-1, remifentanyl 0.1-0.3 μg·kg-1·min-1, sevofrane 0.55%-2% infusion, intravenous bolus cisatracurium 0.05-0.10 mg/kg. The anesthesia related complications and length of hospital stay were recorded. Results Postoperative nausea and vomiting (PONV) respiratory depression of group O was significantly lower than that of group C ［2(11.8%) cases vs 9 (52.9%) cases, P＜0.05］, length of hospital stay of group O was significantly shorter than that of group C ［(10.4±1.6) d vs (15.8±2.0) d, P＜0.05］. Conclusion In the elderly patients with femoral intertrochanteric fracture closed reduction and PFNA internal fixation, oxycodone combined subarachnoid block may improve patients' recovery. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
