蛛网膜下腔阻滞用于超高龄患者髋部手术的临床观察  

Clinical experience of subarachnoid block anesthesia used in super elderly patients with hip surgery

作　　者：顾丽莉[1] 陆丽娟[2] 张中军[1] 叶雷[1] 邹军[1] 

机构地区：[1]江苏省无锡市第三人民医院麻醉科,214041 [2]南京大学医学院附属鼓楼医院疼痛科

出　　处：《临床麻醉学杂志》2014年第11期1107-1109,共3页Journal of Clinical Anesthesiology

摘　　要：目的观察蛛网膜下腔阻滞麻醉用于超高龄患者髋部手术的安全性和临床疗效。方法80岁以上髋部骨折的患者35例,ASAⅡ或Ⅲ级,采用蛛网膜下腔阻滞。观察患者在入室时（T0）和注药后5min（T1）、10 min（T2）、15 min（T3）、30 min（T4）和手术结束时（T5）MAP、HR和SpO2的变化和麻醉效果。结果 35例患者布比卡因的用量（11.15±1.15）mg;手术时间（47.14±18.20）min。T1~T4时MAP明显低于T0时,T1时HR明显快于T0时;T1~T5时SpO2明显高于T0时（P〈0.01或P〈0.05）。所有患者的麻醉感觉阻滞平面控制在T10~T12,注药后患者无呼吸抑制、心慌、胸闷及恶心、呕吐等不良反应。麻醉效果优34例（97.1%）,良1例（2.9%）。结论蛛网膜下腔阻滞麻醉用于80岁以上高龄患者的髋部手术是安全有效的。Objective To observe the safety and clinical efficacy of subarachnoid block anesthesia used in super elderly patients with hip surgery.Methods Choice of 35 patients with hip fracture over the age of 80 years,ASA classⅡ orⅢ,the subarachnoid block anesthesia was adopted.Observing all kinds of vital signs（MAP,HR,SpO2）changes and anesthetic effect of patients when into the operating room（T0）and at different time points 5min（T1）,10min（T2）,15min（T3）,30min（T4）after the injection and the end of the surgery（T5）.Results The amount of bupivacaine patients（11.15 ±1.15）mg;operative time（47.14 ± 18.20）min.MAP at T1-T4 was significantly lower than that at T0,HR at T1 was significantly faster than that at T0;when SpO2 at T1-T5 significantly higher than that at T0（P〈0.01 or P〈0.05）.Sensory block level in all patients anesthesia control in about T10,after injection in patients with no respiratory depression,palpitation,chest tightness,nausea,vomiting and other adverse reactions.Anesthetic effect was excellent in 34（97.1%）,and 1（2.9%）had good results.Conclusion Subarachnoid block anesthesia used in the over 80-year-old aged patients with hip surgery is safe and effective.

关 键 词：蛛网膜下腔阻滞 高龄患者 髋部手术 生命体征 临床疗效 

分 类 号：R614[医药卫生—麻醉学]