低浓度布比卡因用于老年患者椎管内联合麻醉效果观察  

Chinical Study of Combined Spinal-epidural Anesthesia With Low-Concentr ation Bupivacaine in Aged Patients

作　　者：叶军明[1] 谢海玉[1] 冯建伟[1] 赵昭[1] 

机构地区：[1]赣南医学院附属医院麻醉科,江西赣州341000

出　　处：《赣南医学院学报》2004年第5期530-531,共2页JOURNAL OF GANNAN MEDICAL UNIVERSITY

摘　　要：目的 :评价低浓度布比卡因用于老年患者椎管内联合麻醉的临床效果。方法 :选择欲行手术治疗的老年病人 6 8例 ,ASAI-Ⅱ级 ,随机分为两组 ,每组 34例。两组都选择L2～ 3 做穿刺点 ,皆采用椎管内联合麻醉。I组蛛网膜下腔负荷剂量为 0 .1%布比卡因 5ml,Ⅱ组蛛网膜下腔负荷剂量为 0 .5 %布比卡因 2ml,术中根据需要硬膜外腔再注入 0 .2 5 %布比卡因。两组术后接镇痛泵进行术后硬膜外镇痛。观察术中平面扩散范围、运动神经阻滞程度 (改良Bromage评分 ,MBS)、血压及心律下降程度、术中辅助用镇静镇痛药情况。结果 :与Ⅱ组相比 ,I组MBS评分较低 ,但无统计学意义 (P >0 .0 5 )。病人术中辅助用药剂量相当 ;给药 5min血压的下降程度明显降低 (P <0 .0 1)。结论 :低浓度布比卡因用于老年患者椎管内联合麻醉具有局麻药用量少 ,麻醉效果好 ,并发症少等优点 ,对老年病人是一种安全有效的椎管内麻醉方法。Objective:To determine the clinical effect of low-concentra tion bupiva caine for combined spinal-epidural anesthesia(CSEA)in aged patients.Methods:Sixt y-eight patients,ASA class Ⅰ-Ⅱ,65 to 89 years old,under going elective lower l imp or perineum surgery,were randomly divided into two groups of 34 patients in e ach group.Catheter was placed at L 2-3 .Both groups were used combined spina l-epidural anesthesia(CSEA).A loading dose of 0.1% bupivacaine 5 ml (group Ⅰ)or 0.5% bupivacaine 2 ml(group Ⅱ)was given,and the anesthesia was maintained with epidural administration with 0.25% bupivacaine if necessary during the operati on.Postoporative anesthesia was used in both groups.Level of anesthesia was rec orded during surgery.Degree of motor block was measured simultaneously on Modifi ed Bromage Score (MBS).Results:Motor blockade was less intense in group Ⅰ a s assessed by modified Bronge score.Patients received fentangli in during surger y was similar in both groups.Conclusion:0.1% bupivacaine is safe and effective f or combined spinal-epidural anesthesia in aged patients.

关 键 词：布比卡因 联合麻醉 老年人 

分 类 号：R614.42[医药卫生—麻醉学]