文献类型：期刊文献

中文题名：针刺复合小剂量硬膜外麻醉应用于老年下肢骨科手术的临床观察

英文题名：Clinical observation of the application of small-dose epidural anesthesia combining acupuncture for elder patients with lower limb orthopaedic surgeries

作者：冯秀玲[1];王昱[1];魏清琳[2]

第一作者：冯秀玲

机构：[1]甘肃中医学院附属医院麻醉科;[2]甘肃中医学院附属医院针灸科

第一机构：甘肃中医药大学第二附属医院

年份：2011

卷号：37

期号：2

起止页码：48

中文期刊名：兰州大学学报：医学版

收录：CSTPCD

语种：中文

中文关键词：针刺;硬膜外麻醉;老年患者;下肢骨科手术

外文关键词：acupuncture; epidural anesthesia; elder patient; lower limb orthopaedic surgery

摘要：目的探讨针刺复合小剂量硬膜外麻醉在老年下肢骨科手术中的麻醉效果和安全性。方法将60例拟进行下肢骨科手术的老年患者随机分为两组,单纯小剂量硬膜外麻醉组(A组)和针剌复合小剂量硬膜外麻醉组(B组),每组30例。比较两组硬膜外局麻用药量、麻醉效果,监测麻醉前、麻醉后30、60min各时点的心率、收缩压、舒张压、平均动脉压及血糖变化。结果麻醉效果Ⅰ级率A组为83%、B组为93%,两组比较差异有统计学意义(P<0.05);硬膜外腔首次用量A组较B组增加35.5%(P<0.01);在30、60min时A组心率较B组快(P<0.05);A组收缩压、平均动脉压在30、60 min时下降较B组明显(P<0.05或P<0.01);A组血糖水平在30、60min较术前增高(P<0.05)。结论针刺复合小剂量硬膜外麻醉可减少麻醉药用量,循环稳定,术中应激反应轻,可作为老年下肢骨科手术麻醉方法之一。
Objective To observe the effects and security of small dose of epidural anesthesia combining acupuncture for elder patients with lower limb orthopaedic surgeries.Methods 60 cases of elder patients who were about to take lower limb orthopaedic surgeries were randomly divided into two groups,with 30 cases in each group.Group A were simply given small doses of epidural dolantin,while in group B,acupuncture was overlapped basing on the small doses of epidural anesthesia.To compare the drug consumption and anesthetic effects of these two groups, the parameters like heart rate,systolic and diastolic blood pressure,mean arterial pressure,and the change of blood sugar level before the anesthesia,were monitored 30 minutes and 60 minutes after anesthesia.Results TheⅠgrade anesthetic effect rate of A group was 83%,while B group was 93%.The differences were statistically significant（P0.05）.The first drug consumption of A group was 35.5%lower than that of B group（P0.01）.The heart rate in A group was statistically faster than that of B group at both 30 minutes and 60 minutes after anesthesia（P0.05）.The systolic blood pressure and mean arterial pressure in group A declined more at 30 minutes and 60 minutes after anesthesia（P0.05 or P0.01）,but the blood sugar level in group A increased at both 30 minutes and 60 minutes after anesthesia than pre-operation（P0.05）.Conclusion Small dose of epidural anesthesia combining acupuncture can reduce the dosage of anesthesia drugs while keeping the circulation stable and minutesimizing the operative stress reactions.Small dose of epidural anesthesia combining acupuncture can be an anesthesia option for elder patients who are about to take lower limb orthopaedic surgeries.