不同剂量舒芬太尼复合左布比卡因蛛网膜下腔阻滞在老年人工股骨头置换术中的应用  

The application of different dosages of Sufentanil added to Levobupivacaine subarachnoid block in agedness undergone artificial femoral head replacement

作　　者：蔡爱香[1] 徐瞳[1] 冯作炫[1] 

机构地区：[1]福建省宁德市医院麻醉科,福建宁德352100

出　　处：《中国当代医药》2012年第36期79-81,共3页China Modern Medicine

基　　金：福建省卫生厅青年基金项目(2007-2-43)

摘　　要：目的探讨不同剂量舒芬太尼复合左布比卡因蛛网膜下腔阻滞在老年人工股骨头置换术中应用的可行性及最适剂量。方法选择2011年10月～2012年8月本院采用腰硬联合麻醉下行人工股骨头置换术的老年患者30例,年龄70～90岁,ASAⅡ～Ⅲ级,随机分为3组(均n=10),A组:7mg左布比卡因+舒芬太尼3μg。B组:7mg左布比卡因+舒芬太尼4μg;C组:7mg左布比卡因+舒芬太尼5μg,3组患者腰麻药总量均为1.2mL,记录3组患者麻醉前(T1),麻醉后1min(T2)、3min(T3)、5min(T4)、10min(T5)时SBP、DBP、HR、SpO2值;同时观察记录患者感觉阻滞起效时间、运动阻滞起效时间、运动阻滞持续时间、感觉阻滞持续时间以及恶心呕吐、低血压、寒战、皮肤瘙痒、尿潴留等不良反应。结果与A相比,B组T3时SBP、DBP、HR差异有统计学意义(P<0.05)。与术前基础值相比,C组T3、T4、T5时SBP、DBP明显降低,HR明显升高(P<0.05),与A、B相比,C组恶心、呕吐、皮肤瘙痒、寒战不良反应发生率升高(P<0.05)。结论 7mg左布比卡因复合3μg舒芬太尼蛛网膜下腔阻滞可安全有效的应用于老年人工股骨头置换术,并能维持血流动力学相对稳定,且不良反应发生率低。Objective To investigate the application feasibility and optimal dose with different dosages of Sufentanil added to Levobupivacaine subarachnoid block in agedness undergone artificial femoral head replacement.Methods Thirty ASA Ⅱ or Ⅲ patients aged 70-90 years undergone femoral head replacement with combined spinal-epidural anesthesiat were enrolled during Octorber 2011 and August 2012 in our hospital,they were randomly divided into three groups（n = 10）.Group A：7 mg Levobupivacaine and 3 μg sufentanil;Group B：7 mg Levobupivacaine and 4 μg Sufentanil;Group C：7 mg Levobupivacaine and 5 μg Sufentanil,the narcotic amount of each group was 1.2 mL,the SBP、DBP、HR、SpO2 were recorded before anesthesia（T1）,afer anesthesia 1 min（T2）,3 min（T3）,5 min（T4）,10 min（T5）;Anesthesia block onset time,motion block onset time,motion block duration time,anesthesia block duration time and nausea and vomiting,low blood pressure,shivers,itchy,urinary retention were also recorded.Results Compared with group A,at T3 in group B the SBP,DBP,HR were obvious difference（P 〈0.05）,the SBP,DBP obviously decreased,but HR increased in goup B compared with basic value（P 〈0.05）;Compared with group A,group C at T3,T4,T5 the SBP,DBP,HR were obvious difference（P 〈0.05）.Compared with the basic value,group C at T3,T4,T5 the SBP,DBP obviously decreased,HR significantly increased（P 〈0.05）,compared with group A,B,group C in nausea,vomiting,itchy,chill adverse reaction were increased（P 〈0.05）.Conclusion The application of 7 mg Levobupivacaine plus 3 μg Sufentanil subarachnoid block is safe and effective in agedness undergone artificial femoral head replacement,and the adverse reaction rate is also lower.

关 键 词：舒芬太尼 左布比卡因 蛛网膜下腔阻滞 不同剂量 

分 类 号：R614.4[医药卫生—麻醉学]