左旋布比卡因复合舒芬太尼腰硬联合麻醉在髋关节置换术中的应用  

Application of Combined Levobupivacaine and Sufantanyl Spinal-epidural Anesthesia in Total Hip Arthroplasty

作　　者：谢瑜[1] 

机构地区：[1]湖南省娄底市中心医院麻醉科,湖南娄底417000

出　　处：《中国现代医生》2009年第28期15-17,共3页China Modern Doctor

摘　　要：目的观察小剂量左旋布比卡因复合舒芬太尼腰麻-硬膜外联合麻醉在老年人髋关节置换术中的临床效果。方法我院自2006年1月～2008年10月收入的椎管内麻醉下行老年人髋关节置换术110例,随机分为两组:舒芬太尼组,左旋布比卡因5mg加舒芬太尼25μg与10%葡萄糖水配成2.5mL溶液,55例;对照组,左旋布比卡因7.5mg与10%葡萄糖水配成2.5mL溶液,55例。用改良Bromage评分法判断运动神经阻滞程度,记录患者运动神经阻滞起效时间、持续时间,并观察患者恶心、呕吐、寒战、低血压等不良反应发生情况。结果与对照组相比,舒芬太尼组起效时间明显缩短(P<0.05),持续时间显著低于对照组(P<0.05),两组Bromage分级无明显差异(P>0.05)。舒芬太尼组术后恶心、呕吐,寒战和低血压的发生率显著少于对照组(P<0.05)。结论小剂量左旋布比卡因复合芬太尼腰麻-硬膜外联合麻醉用于老年人髋关节置换术具有起效快,维持时间长的优点,可以满足手术的麻醉需求,值得临床推广。Objective To investigate the clinical effects of low analgesic dose of intrathecal levobupivacaine combined with sufantanyl in total hip arthroplasty in the elderly. Methods We divided 110 cases of total hip arthroplasty into sufantanyl group（55） and control group（55） from Jun 2006 to Oct 2008 in our hospital. The sufantanyl group was anesthetized with levobupivacaine 5mg combinated with sufantanyl 25 μ g and 10% glucose liquor to a total amount of 2.5mL. The control group was anesthetized with levobupivacaine 7.5mg with sufantanyl 25 μg and and 10% glucose liquor to a total amount of 2.5mL. We used modified Bromage score to justify the degree of nerve block and obverved the onset time and recovery time of nerve block and the adverse reaction（nausea and vomiting, chill and hypotension） in both groups. Results The sufantanyl group had shorter onset time and less duration compared with the control group（P〈 0.05）. The two group had no statistical significance in Bromage score（P〉 0.05）. The incidence of nausea and vomiting, chill and hypotension in the sufantanyl group was significantly lower compared with the control group（P 〈 0.05）. Both groups had no respiratory depression. Conclusion Low analgesic dose of intrathecal levobupivacaine combined with sufantanyl in total hip arthroplasty in the elderly has the advantages of a fast onset of action and a longer maintaining time to meet the needs of surgical anesthesia, worthy to be popularized.

关 键 词：左旋布比卡因 舒芬太尼 椎管内麻醉 

分 类 号：R614.4[医药卫生—麻醉学]