摘要
目的:探讨罗哌卡因腰硬联合麻醉对髋部及下肢骨折患者的应用效果与术后认知功能的影响。方法:回顾性分析2024年4—12月新泰市人民医院收治的80例髋部及下肢骨折患者资料,根据麻醉方法的不同将其分为对照组(n=35)和研究组(n=45)。研究组采取罗哌卡因腰硬联合麻醉,对照组采取布比卡因腰硬联合麻醉。对比两组血流动力学指标、感觉阻滞参数、应激反应指标、认知功能及不良反应发生情况。结果:麻醉后15、30 min及术毕,研究组心率均高于对照组,差异均有统计学意义(P<0.05)。研究组感觉平面固定时间、感觉阻滞持续时间均长于对照组,差异均有统计学意义(P<0.05)。麻醉后25 min及术毕,研究组皮质醇、儿茶酚胺水平均低于对照组,差异均有统计学意义(P<0.05)。麻醉后2 h、1 d,研究组简易精神状态量表、蒙特利尔认知评估量表评分均高于对照组,差异均有统计学意义(P<0.05)。研究组不良反应发生率为2.22%,低于对照组的20.00%,差异有统计学意义(P<0.05)。结论:罗哌卡因腰硬联合麻醉对髋部及下肢骨折患者血流动力学指标影响较小,有利于延长感觉阻滞时间,减轻应激反应,提高术后认知功能,降低不良反应发生率。
Objective:To investigate the influence of Ropivacaine combined spinal-epidural anesthesia on the effect of application and postoperative cognitive function in patients with hip and lower limb fractures.Methods:A retrospective analysis was conducted on 80 patients with hip and lower limb fractures admitted to Xintai People’s Hospital from April to December 2024.They were divided into a control(n=35)group and a study(n=45)group according to the different anesthesia methods.The study group was given with Ropivacaine combined spinal-epidural anesthesia,the control group was given Bupivacaine combined spinal-epidural anesthesia.The hemodynamics indicators,sensory block parameters,stress response,indicators cognitive function and occurrence of adverse reactions were compared between the two groups.Results:At 15 and 30 min after anesthesia,after surgery,the heart rate of the study group were higher than those of the control group,the difference were statistically significant(P<0.05).The time of sensory plane fixed and the duration of sensory block in the study group were longer than those in the control group,the difference were statistically significant(P<0.05).At 25 min after anesthesia and after surgery,the levels of cortisol and catecholamines in the study group were lower than those in the control group,the difference were statistically significant(P<0.05).At 2 h and 1 day after anesthesia,the scores of the Mini-Mental State Scale and the Montreal Cognitive Assessment Scale in the study group were higher than those in the control group,the difference were statistically significant(P<0.05).The incidence of adverse reactions in the study group was 2.22%,which was lower than 20.00%in the control group,the difference was statistically significant(P<0.05).Conclusion:Ropivacaine combined spinal-epidural anesthesia has little effect on hemodynamic indexes in patients with hip and lower limb fractures,which is conducive to prolonging sensory block,reducing stress response,improving postoperative cognitive function,and reducing the incidence of adverse reactions.
作者
王成美
WANG Chengmei(Department of Anesthesiology,Xintai People’s Hospital,Tai,an 271000,China)
出处
《中国伤残医学》
2025年第9期83-87,共5页
Chinese Journal of Trauma and Disability Medicine
关键词
髋部骨折
下肢骨折
罗哌卡因
布比卡因
腰硬联合麻醉
髋关节置换术
下肢骨折手术
Hip fracture
Lower limb fracture
Ropivacaine
Bupivacaine
Combined spinal-epidural anesthesia
Hip replacement surgery
Lower limb fracture surgery
