摘要
目的探讨在全膝关节置换术的老年患者中,不同体位对硬膜外导管拔除力的影响。方法行全膝关节置换术的老年患者62例,采用随机数字表法分为侧卧位组(n=21)、坐立位组(n=20)和俯卧位组(n=21)。术前在侧卧位行腰硬联合麻醉,术后于指定体位拔除硬膜外导管,记录各组硬膜外导管拔除的峰值张力。多元线性回归分析评估患者基线特征和穿刺针深度、置管长度和留置时间等变量与拔除力间的关系。结果侧卧位组的硬膜外导管拔除力为1.5N(0.12～3.92),显著小于俯卧位组(3.8N(0.34～10.12))和坐立位组(4.2(0.04～9.93))(P<0.001)。硬膜外腔置管长度与拔除的峰值张力呈正相关(P=0.010,β系数=0.276)。结论患者取侧卧位和适当的硬膜外置管长度可减小拔除导管所需的张力。
Objective To investigate the effect of different body positions on the extraction force of epidural catheters in elderly patients undergoing total knee arthroplasty.Methods Sixty-two elderly patients undergoing total knee arthroplasty were randomly divided into the lateral position group(n=21),the sitting position group(n=20)and the prone position group(n=21).The lumbar and spinal anesthesia was performed in the lateral position before operation.The epidural catheter was removed at the specified position and the peak tension of the epidural catheter was removed.Multiple linear regression analysis was used to assess the relationship between baseline characteristics and needle depth,catheter length and retention time,and extraction force.Results The epidural catheter extraction force of the lateral position group was 1.5N(0.12~3.92),which was significantly smaller than that of the prone position group(3.8N(0.34~10.12))and that of the sitting position group(4.2(0.04~9.93))(P<0.001).The length of the epidural catheter was positively correlated with the peak tension of the extraction(P=0.010,beta coefficient=0.276).Conclusion The patient's lateral position and appropriate length of epidural catheter can reduce the tension required to remove the catheter.
作者
赵敏杰
程浩
ZHAO Minjie;CHENG Hao(The Affiliated Hospital of Shaoxing University,Zhejiang 312000,China)
出处
《浙江创伤外科》
2019年第1期6-8,共3页
Zhejiang Journal of Traumatic Surgery
关键词
全膝关节置换术
腰硬联合麻醉
硬膜外导管
体位
Total knee arthroplasty
Combined spinal and epidural anesthesia
Epidural catheter
Position
