单侧腰麻用于高龄患者髋关节置换术的临床观察  

The Clinical Observation of Unilateral Spinal Anesthesia with Hip Replacement Surgery on Very Elderly Patients

作　　者：熊朝晖[1] 陈运良[1] 秦素兰[1] 王波[1] 刘文良[1] 

机构地区：[1]广安市人民医院麻醉科,四川广安638000

出　　处：《四川医学》2014年第9期1165-1167,共3页Sichuan Medical Journal

摘　　要：目的 观察单侧腰麻在高龄患者髋关节置换手术应用的麻醉效果及其对血流动力学的影响。方法 选择年龄80-99岁,ASA分级Ⅱ-Ⅲ级行髋关节置换手术的患者40例,随机分成分两组,单侧腰麻组（A组）和常规腰麻组（B组）,均以0.375%重比重布比卡因2mL为麻醉药,分别评定麻醉效果,记录两组麻醉起效时间、阻滞平面术始、术毕双下肢的Bromage评分及不良反应。结果 两组患者术中麻醉效果均满意。A组低血压、尿潴留发生率明显低于B组（P〈0.05）,A组各时点健肢Bromage评分明显低于患肢（P〈0.05）,两组患者麻醉起效时间、麻醉平面及维持时间差异无统计学意义（P〉0.05）。结论 单侧腰麻用于高龄患者髋关节置换手术麻醉效果好,对患者血流动力学影响小,不良反应少,是一种可行而效果好的麻醉方法。Objective To determine the effect of unilateral spinal anesthesia with hip replacement surgery on very elderly patients. Methods Forty patients aged 80 to 99 years old undergoing hip replacement surgery were devided randomly into two groups with 20 cases each and both received hyperbaric 0. 375% bupivacaine 2mL. Group A received unilateral spinal anesthesia and group B received general spinal anesthesia. The anesthetic effect and Bromage score were recored. Results All patients achieved satisfactory block. The incidence of hypotension and uroschesis in group A were lower than that in group B（P〈0. 05）. The Bromage score of right lower limb were lower than those the broken one in group A（P〈0. 05）. Conclusion Unilateral spinal anesthesia with hip replacement surgery on very elderly patients provided less hemodynamic changes and less complications.

关 键 词：单侧腰麻 高龄 髋关节置换 

分 类 号：R614[医药卫生—麻醉学]