轻比重罗哌卡因用于高龄患者腰-硬联合麻醉髋关节手术的临床观察  

Clinical observation of the combined spinal-epidural anesthesia in aged patients undergoing hip arthroplasty surgery

作　　者：汪国海[1] 焦文成[1] 

机构地区：[1]东莞市太平人民医院麻醉科, 广东省东莞523900

出　　处：《中国基层医药》2014年第2期197-199,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 观察高龄患者髋关节手术小剂量罗哌卡因腰-硬联合麻醉的效果及对呼吸循环功能的影响.方法 ASAⅡ或Ⅲ级髋关节手术40例,随机均分为两组,每组20例.A组蛛网膜下腔阻滞（腰麻）用轻比重0.25％罗哌卡因5～7 mg,硬膜外阻滞用0.25％罗哌卡因；B组腰麻用重比重0.5％布比卡因8～10 mg,硬膜外阻滞用0.375％布比卡因.记录两组麻醉效果和术中BP、HR、脉博氧饱和度（SpO2）变化.结果 A组麻醉平面T8～T10,单侧,术中各时点BP、HR、SpO2平稳,Bromage评分患肢1～2分,健肢0～1分；B组麻醉平面T6～T8,双侧,术中各时点BP明显下降,HR明显减慢,Bromage评分双下肢以3～4分为主.结论 轻比重罗哌卡因腰-硬联合麻醉更适用于高龄髋关节手术患者.Objective To observe the effects of combined spinal-epidural anesthesia （CSEA） with small dose of ropivacaine on the circulatory and respiratory function in aged patients undergoing hip arthroplasty surgery.Methods Forty ASA Ⅱ or Ⅲ patients were randomly divided into two groups,20 cases in each group.In group A,0.25% ropivacaine 5-7mg was given for spinal block and 0.25% ropivacaine for epidural block.Patients in group B were given 0.5 % bupivacaine 8-10mg and 0.375% bupivacaine,respectively.The anesthetic efficacy,BP,HR,SpO2,Bromage score were recorded.Results The analgesic plane was T8-T10 in group A,and that was T6-T8 in group B.The changes of BP,HR,SpO2 in group A were less than those in group B.Bromage scores of group A were 1-2 for nonoperative extremity and 0-1 for the operative extremity,which were 3-4 for two extremities in group B.Conclusion The CSEA with 0.25% ropivacaine 5-7mg for spinal block and 0.25% ropivacaine for epidual block is suitable for patients undergoing hip arthroplasty surgery.

关 键 词：腰-硬联合麻醉 髋关节手术 老年人 

分 类 号：R614.4[医药卫生—麻醉学]