全身麻醉与硬膜外麻醉在老年骨科手术中的应用效果分析

目的分析在老年骨科手术中应用硬膜外麻醉与全身麻醉的效果。方法108例接受骨科手术治疗的老年患者,采用随机数字表法分为对照组和实验组,每组54例。对照组患者给予全身麻醉,实验组患者给予硬膜外麻醉。比较两组患者的围术期指标、麻醉前后认识功能。结果实验组患者手术时间、麻醉时间、下床活动时间、住院时间分别为(138.57±2.88)min、(160.25±4.29)min、(7.88±0.94)d、(15.06±1.91)d,短于对照组的(143.76±3.64)min、(168.32±3.77)min、(9.72±1.41)d、(18.14±1.65)d,差异具有统计学意义(P<0.05)。麻醉后6 h、12 h、1 d,两组患者简易智力状态检查量表(MMSE)评分均较本组麻醉前降低,但实验组患者MMSE评分(27.43±1.02)、(25.33±0.61)、(26.53±0.41)分高于对照组的(24.95±0.96)、(23.87±0.52)、(25.04±0.62)分,差异具有统计学意义(P<0.05)。结论相比全身麻醉,在老年骨科手术中应用硬膜外麻醉具有更加理想的效果,患者的手术时间及麻醉时间均更短,认知功能影响更小,下床活动更早,能够促进患者早日康复出院,值得在临床中积极推广应用。

Effect analysis of general anesthesia and epidural anesthesia in orthopedic surgery for the elderly

Objective To analyze the effect of general anesthesia and epidural anesthesia in orthopedic surgery for the elderly.Methods A total of 108 elderly patients undergoing orthopedic surgery were divided into control group and experimental group according to random numerical table,with 54 cases in each group.Patients in the control group received general anesthesia,and patients in the experimental group received epidural anesthesia.The perioperative indicators and cognitive function before and after anesthesia were compared between the two groups.Results The operation time,anesthesia time,off-bed activitye time,and hospitalization time in the experimental group were(138.57±2.88)min,(160.25±4.29)min,(7.88±0.94)d,and(15.06±1.91)d,which were shorter than(143.76±3.64)min,(168.32±3.77)min,(9.72±1.41)d,and(18.14±1.65)d in the control group,and the difference was statistically significant(P<0.05).At 6 h,12 h,and 1 d after anesthesia,the MMSE scores of the two groups were lower than those of this group before anesthesia,but the MMSE scores of the experimental group were(27.43±1.02),(25.33±0.61),and(26.53±0.41)points,which were higher than(24.95±0.96),(23.87±0.52),and(25.04±0.62)points of the control group.All differences were statistically significant(P<0.05).Conclusion Compared with general anesthesia,epidural anesthesia has a more ideal effect in orthopedic surgery for the elderly,with shorter operation time and anesthesia time,less impact on cognitive function,and earlier off-bed activity,which can promote the early discharge of patients,and is worthy of actively promotion and application in clinical practice.