罗哌卡因复合氢吗啡酮单侧腰麻在老年下肢手术中的应用及罗哌卡因最低有效剂量研究  

Application of Ropivacaine Combined with Hydromorphone Unilateral Spinal Anesthesia in Elderly Lower Limb Surgery and the Study of the Lowest Effective Dose of Ropivacaine

作　　者：姜攀 JIANG Pan(Jinhua Wenrong Hospital,Jinhua 321000,China)

机构地区：[1]金华文荣医院,浙江省金华市321000

出　　处：《中国全科医学》2021年第S02期132-134,共3页Chinese General Practice

摘　　要：目的研究分析罗哌卡因复合氢吗啡酮单侧腰麻在老年下肢手术中罗哌卡因最低有效剂量和临床效果。方法选择金华文荣医院2018年9月至2019年9月接受单侧下肢手术老年患者80例为研究对象,患者均接受单侧腰麻麻醉,麻醉用药罗哌卡因复合氢吗啡酮,采用双盲随机方法由不同麻醉师分别配置所用不同剂量的罗哌卡因复合液进行麻醉,评价不同剂量罗哌卡因麻醉效果寻找最低有效剂量,记录患者麻醉前(T0)、麻醉后5 min(T1)、麻醉到达有效平面(T2)、术中(T3)、手术结束(T4)各时间点平均动脉压(MAP)及心率(HR)。结果罗哌卡因ED50和罗哌卡因95%可信区间类似,因此罗哌卡因7.5 mg为最低有效剂量;高剂量和低剂量患者在麻醉各时间点MAP和HR指标比较,差异均无统计学意义(P>0.05)。结论罗哌卡因7.5 mg用于老年患者下肢手术单侧腰麻用药量少,手术时间短,对患者循环系统抑制较轻,术中管理安全、有效、简单,适用于自身合并高危肺、心肌病下肢手术患者,可作为临床使用依据。Objective To study and analyze the lowest effective dose and clinical effect of ropivacaine combined with hydromorphone in elderly lower limb surgery.Method 80 elderly patients who underwent unilateral lower limb surgery in Jinhua Wenrong Hospital from September 2018 to September 2019 were selected as the research objects.All patients received unilateral spinal anesthesia.The anesthetic drug ropivacaine combined with hydromorphone was used.Different doses of ropivacaine compound solution were prepared by different anesthesiologists by double-blind random method,Evaluate the anesthetic effect of different doses of ropivacaine,find the lowest effective dose,and record the mean arterial pressure(MAP)and heart rate(HR)at each time point before anesthesia(T0),5 minutes after anesthesia(T1),anesthesia reaching the effective level(T2),during operation(T3)and at the end of operation(T4).Results The 95%confidence interval of ropivacaine ED50 is similar to that of ropivacaine,so ropivacaine 7.5 mg is the lowest effective dose;There was no significant difference in MAP and HR between high-dose and low-dose patients at each time point of anesthesia(P>0.05).Conclusion Ropivacaine 7.5mg is used in elderly patients with lower limb surgery,with less dosage of unilateral spinal anesthesia,short operation time,less inhibition of patients’circulatory system,safe,effective and simple intraoperative management.It is suitable for patients with high-risk pulmonary and cardiomyopathy,and can be used as a basis for clinical use.

关 键 词：麻醉 罗哌卡因 氢吗啡酮 老年人 最低有效剂量 单侧腰麻 

分 类 号：R614[医药卫生—麻醉学]