小剂量罗哌卡因和布比卡因复合舒芬太尼腰麻对老年病人血流动力学影响的比较  

Comparison of Hemodynamic effects of low does bupivacaine or ropivacaine, combined with sufentanil , in spinal anaesthesia in Geriatric Patients

作　　者：刘茂东[1] 彭为平[1] 莫平[1] 邵泳尧[1] 郑映金[1] 梁秀萍[1] 

机构地区：[1]广东省佛山市南海区人民医院麻醉科,528200

出　　处：《医学信息（下旬刊）》2011年第4期12-13,共2页Medical information

摘　　要：目的：罗哌卡因12mg复合舒芬太尼5ug 和布比卡因8mg复合舒芬太尼5ug腰麻用于老年病人TURP手术,比较两种方法对血流动力学的影响.方法：60例ASA分级I或II级病人60例,欲在腰硬联合麻醉下行TURP 手术,随机分为两组,R组（罗哌卡因组）和B（布比卡因组）,R组病人鞘内给予罗哌卡因12mg舒芬太尼5mg用生理盐水稀释至3ml,B组病人鞘内给予布比卡因8mg舒芬太尼5mg用生理盐水稀释至3ml,记录围术期病人的收缩压、舒张压、心率,发生心动过缓、需要用麻黄素处理低血压的例数以及恶心呕吐、瘙痒的例数.结果：腰麻后两组病人的收缩压、舒张压和心率均明显下降,组间比较收缩压在60min和120min,舒张压在5min 10min 30min 60min,心率在15min 30min 布比卡因组均明显低于罗哌卡因组.结论：12mg罗哌卡因和8mg布比卡复合舒芬太尼5ug腰麻能为老年病人TURP手术提供良好的麻醉效果,而罗哌卡因对血流动力学的影响要低于布比卡因.Objective The aim of this study was to compare the haemodynamic and side effects of 12mg ropivacaine and 8mg bupivacaine , both with 5ug sufentanil ,in spinal anaesthesia for TURP surgery in geriateic patients Methords Sixty ASA I or II Patients scheduled for TURP surgery were randomly divided into two groups , B（Bupivacaine group）and R（Ropivaeaine group ）, B group received intrathecal injection of 8rag bupivaine and S ug sufentanil , which was diluted to 3ml by 0.9% NS, R group received intrathecal injection of 12rag ropivacaine and S ug sufentanil, which was diluted to 3ml by 0.9%NS. The peri--operative SAP .DAP .HR and side effects such as Itching .Nausea/vomiting and Bradycardia,so did the incidence of hypotension need treatment with ephedrine. Results The SAP.DAP and HR were lower after the spinal anaesthesia, The SAP after anaesthesia 60 min and 120min, the DAP after anaesthesia Smin. 10min. 30min and 60min and the HR after anaesthesia 15tain and 30min were lower in B group than that of R group. Conclusions 12rag Ropivacaine and 8mg bupivacaine ,combined with 5ug sufentanil in spinal anaesthesia can provide sufficient anaesthesia for TURP surgery in Geriatric patients ,while the effects on hamodymamic of ropivacaine was lower than bupivacaine.

关 键 词：罗哌卡因 布比卡因 舒芬太尼 腰麻 TURP 血流动力学 

分 类 号：R614[医药卫生—麻醉学]