不同剂量舒芬太尼复合罗哌卡因腰麻在高龄患者手术中的应用  

Spinal anesthesia with ropivacaine combined with sufentanil in the elder patients

作　　者：张彩玲[1] 陈伟元[1] 

机构地区：[1]梅州市人民医院麻醉三科,广东梅州514000

出　　处：《海南医学》2014年第7期977-979,共3页Hainan Medical Journal

基　　金：梅州市卫生局计划项目(编号:2013-B-4)

摘　　要：目的探讨不同剂量舒芬太尼复合罗哌卡因腰麻用于高龄患者手术的有效性和安全性。方法选择150例85岁及以上择期行会阴部及下肢手术患者,随机分为三组:A组50例给予7.5 mg 0.5%罗哌卡因+1.5μg舒芬太尼;B组50例给予7.5 mg 0.5%罗哌卡因+2.5μg舒芬太尼;C组50例给予7.5 mg 0.5%罗哌卡因+3.5μg舒芬太尼。比较三组患者的感觉运动阻滞情况、血流动力学变化以及腰麻后的副反应。结果在血流动力学方面,三组麻醉后的MAP值、HR值比较差异均无统计学意义(P>0.05)。在感觉和运动阻滞疗效方面,B、C组明显优于A组(P<0.05),但B、C组比较差异无统计学意义(P>0.05)。在腰麻后副反应中,除C组的尿潴留发生率显著高于A、B组(P<0.05),其余副作用的发生率未见明显增加(P>0.05)。结论小剂量的舒芬太尼复合罗哌卡因腰麻可安全有效应用于高龄患者手术,其中以7.5 mg 0.5%罗哌卡因复合2.5μg舒芬太尼麻醉效果最佳,不良反应少。Objective To discuss the clinical effectivity and safety of spinal anesthesia with ropivacaine combined with sufentanil in the elderly. Methods Spinal anesthesia was performed in 150 patients, aged more than 85 years old and undergoing selective lower limb surgery, who were equally randomized into three groups. A group re- ceived 0.5% ropivaeaine 7.5 mg plus sufentanil 1.5 μg.B group received 0.5% ropivacaine 7.5 mg plus sufentanil 2.5 μg. C group received 0.5% ropivacaine 7.5 mg plus sufentanil 3.5 μg. Compare the situation of sensorimotor block, hemodynamic changes, and side effects in three groups after spinal anesthesia. Results The MAP, HR of three group after spinal anesthesia had no significant difference among them. In terms of sensorimotor block effect, B group and C group were better than group A （P〈0.05）, but there was no statistical significance between B group and C group. At the comparisons of side effects after spinal anesthesia, only the incidence of urinary retention in group C was significantly higher than that in group A and group B （P〈0.05）, the incidence of the side effects were not increas- ing significantly. Conclusion Small dose of ropivacaine combined with sufentanil can be effectively and safely ap- plied to elderly patients with operation. The scheme of 0.5% ropivacaine 7.5 mg plus sufentanil 2.5 μg among them has the best effect and the minimum side effects.

关 键 词：舒芬太尼 罗哌卡因 腰麻 高龄患者 

分 类 号：R614.3[医药卫生—麻醉学]