不同浓度罗哌卡因腰硬联合麻醉用于人工髋关节置换手术对患者麻醉效果和术后运动功能的影响

摘要 目的：探讨不同浓度罗哌卡因腰硬联合麻醉用于人工髋关节置换手术对患者麻醉效果和术后运动功能的影响。方法：2017年2月至2019年12月选择在本院进行人工髋关节置换手术的患者84例，根据随机数字表法把患者分为观察组与对照组各42例。两组都给予腰硬联合麻醉，对照组采用常规浓度0.5 %罗哌卡因麻醉观察组采用低浓度0.375 %罗哌卡因麻醉，记录患者麻醉效果和术后运动功能变化情况。结果：观察组的麻醉持续时间、运动恢复时间和感觉运动时间都显著短于对照组(P<0.05)。观察组麻醉后10 min、30 min、60 min的Bromage评分都低于对照组(P<0.05)。观察组术后7 d的低血压、恶心呕吐、头晕头痛、尿潴留等不良反应发生率为7.1 %，显著低于对照组的19.0 %(P<0.05)。两组所有患者在术后2 h、术后4 h、术后24 h的呼吸、心率均在正常范围内波动，组间与组内对比都无统计学意义(P>0.05)。结论：低浓度罗哌卡因腰硬联合麻醉用于人工髋关节置换手术能改善患者的麻醉效果和运动功能，提高麻醉效果，并不影响患者的生命体征，且能减少术后不良反应的发生。

Effects of Different Concentrations of Ropivacaine Combined Spinal-epidural Anesthesia on Artificial Hip Replacement Surgery on Patients' Anesthesia Effect and Postoperative Motor Function

ABSTRACT Objective: To investigate the effects of different concentrations of ropivacaine combined spinal-epidural anesthesia on artificial hip replacement surgery on patients'' anesthesia effect and postoperative motor function. Methods: From February 2017 to December 2019, 84 cases of patients underwent artificial hip replacement surgery in our hospital were selected and were equally divided into observation group and control group accorded to random number table method. Both groups were given combined spinal-epidural anesthesia. The control group were anesthetized with conventional concentration of 0.5 % ropivacaine. The observation group were anesthetized with low concentration of 0.375 % ropivacaine. Results: The duration of anesthesia, motor recovery time and sensorimotor time in the observation group were significantly shorter than those in the control group (P<0.05). The Bromage scores of the observation group at 10 min, 30 min, and 60 min after anesthesia were lower than those of the control group (P<0.05). The incidence of low blood pressure, nausea and vomiting, dizziness and headache, urinary retention and other adverse reactions in the observation group were 7.1 % at 7 days after operation, which were significantly lower than 19.0 % in the control group (P<0.05). The breathing and heart rate of all patients in the two groups at 2 h, 4 h and 24 h postoperatively fluctuated within the normal range, and there were no statistically significant difference compared between the groups and within the group (P>0.05). Conclusion: Low-concentration ropivacaine combined spinal-epidural anesthesia for artificial hip replacement surgery can improve the patient''s anesthesia and motor function, improve the anesthesia effect, it does not affect the patient ''s vital signs, and it can reduce the incidence of postoperative adverse reactions.