轻比重布比卡因单侧腰麻在高龄患者下肢手术的临床研究  

Hypobaric bupivacaine unilateral spinal anesthesia in elderly patients with unilateral lower limb surgery in clinical research

作　　者：王华 

机构地区：[1]广东省东莞市大岭山医院麻醉科,523820

出　　处：《中国实用医药》2011年第35期17-18,共2页China Practical Medicine

摘　　要：目的探讨单侧腰麻用于高龄患者下肢手术的可行性,比较不同剂量轻比重布比卡因在高龄患者下肢手术中的临床效果。方法 90例行下肢手术的高龄患者随机分为A、B、C3组,3组腰麻液用量分别为:0.25%轻比重布比卡因5、7、9mg,比较三组临床麻醉效果及不良反应的差异性。结果 3种不同的布比卡因剂量均可产生一个单侧感觉、运动神经阻滞的麻醉效果。A组与B组比较:麻醉起效时间、麻醉平面固定时间、有效镇痛时间、发生低血压例数,差异无统计学意义(P>0.05);C组与A、B组比较:麻醉起效时间、麻醉平面固定时间,差异无统计学意义(P>0.05),但在麻醉有效镇痛时间上C组明显优于A、B组,差异有统计学意义(P<0.01),C组发生低血压例数较A、B组多,差异有统计学意义(P<0.05)。结论 3种不同的布比卡因剂量均可产生一个单侧感觉、运动神经阻滞的麻醉效果,轻比重布比卡因单侧腰麻在高龄患者下肢手术的合适剂量为5-7mg。Objective To investigate the unilateral spinal anesthesia for lower limb surgery in elderly patients the possibility to compare different doses of hypobaric bupivacaine for lower limb surgery in elderly patients in clinical effects.Methods 90 elderly routine lower extremity surgery were randomly divided into A,B,C three groups,three groups of spinal fluid volume were：0.25% hypobaric bupivacaine 5,7,9 mg,compared three groups of clinical anesthesia and differences in adverse reactions.Results Three different doses of bupivacaine may produce a unilateral sensory and motor nerve block anesthesia.A group and B group：The onset time of anesthesia,anesthesia fixed time,effective analgesia,hypotension number of cases,the difference was not statistically significant（P0.05）.C group and A,B group：from anesthesia onset time,anesthesia time fixed,the difference was not statistically significant（P0.05）,but an effective analgesic in anesthesia time was significantly better than group C on A,B group,the difference was statistically significant（P0.01）,C group the number of cases of hypotension compared with A,B group and more,the difference was statistically significant（P0.05）.Conclusion 3 different doses of bupivacaine may produce a unilateral sensory and motor nerve block anesthesia,spinal anesthesia with hypobaric bupivacaine unilateral lower limb surgery in elderly patients with the appropriate dose of 5~7 mg.

关 键 词：腰硬联合麻醉 腰麻 高龄老年人 轻比重布比卡因 

分 类 号：R614[医药卫生—麻醉学]