罗哌卡因单侧腰麻在高龄患者下肢手术中的安全性与有效性评价  

Safety and efficacy evaluation of Ropivacaine unilateral spinal anesthesia in elderly patients with lower extremity operation

作　　者：朱小勇[1] 

机构地区：[1]浙江萧山医院麻醉科,浙江杭州311200

出　　处：《中国医药导报》2015年第10期110-113,共4页China Medical Herald

摘　　要：目的观察并探讨罗哌卡因单侧腰麻在高龄患者下肢手术中的麻醉效果。方法选择2013年5月~2014年4月在浙江萧山医院接受下肢手术的老年患者80例,随机将其分为观察组和对照组,各40例。观察组给予罗哌卡因进行单侧蛛网膜下腔阻滞麻醉,而对照组则给予罗哌卡因连续硬膜外麻醉。麻醉前（T0）、达到有效麻醉平面时（T1）、术中2 h（T2）和术毕（T3）期间测定患者的心率（HR）和平均动脉压（MAP）,统计两组患者寒战和恶心等不良反应发生情况。结果观察组感觉阻滞起效时间和持续时间分别为（1.7±0.5）、（126.2±9.5）min,而对照组为（2.0±0.4）、（79.1±11.0）min,两组比较差异有统计学意义（P〈0.05或P〈0.01）。观察组患者术中寒战与恶心发生例数分别为2例（4.2%）、3例（6.3%）,对照组为9例（18.8%）、10例（20.8%）,两组比较差异有统计学意义（P〈0.05）;两组均无局麻药毒性反应。对照组各时间点HR和MAP变化差异无统计学意义（P〉0.05）,与T0比较,观察组T1时HR和MAP显著下降（P〈0.05）,两组T1时HR和MAP比较,差异有高度统计学意义（P〈0.01）。结论罗哌卡因进行单侧蛛网膜下腔阻滞在高龄患者下肢手术中麻醉效果较好,患者寒战和恶心情况显著改善,且术后不良反应更少。Objective To observe and explore the safety and efficacy of Ropivacaine unilateral spinal anesthesia in elderly patients with lower extremity operation.Methods Eighty elderly patients accepted lower extremity operation in Xiaoshan Hospital from May 2013 to April 2014 were selected,the patients were randomly divided into observation group and control group,each group with 40 cases,patients in the observation group accepted unilateral subarachnoid block anesthesia of Ropivacaine,while the control group received multiple subarachnoid block anesthesia of Ropivacaine.Heart rate（HR） and mean arterial pressure（MAP） were measured at the time before anesthesia（T0）,anesthesia achieve effective anesthesia（T1）,2 h during intraoperative（T2） and after surgery（T3）,the incidence of adverse reactions of maternal chills and nausea intraoperative and postoperative in the two groups were recorded and compared.Results Sensory block onset time and duration in observation group was（1.7±0.5）,（126.2±9.5） min,which in the control group was（2.0±0.4）,（79.1 ±11.0） min,the differences between the two groups were statistically significant（P〈0.05 or P〈0.01）;the number of chills and stretch in observation group was 2 cases（4.2%） and 3 cases（6.3%）,which in the control group was 9 cases（18.8%） and 10 cases（20.8%）,the differences between the two groups were statistically significant（P〈0.05）;no one had toxicity of local anesthetics in two groups.No statistically significant changes were observed at each time point in control group（P〉0.05）.Compared with T0,HR and MAP at T1 in observation group was decreased（P〈0.05）,the differences of HR and MAP at T1 between the two groups were statistically significant（P〈0.01）.Conclusion Unilateral subarachnoid block anesthesia of Ropivacaine has a significant effect for patients in lower extremity operation,as well as can significantly relieve the pregnant chills and nausea,which has less adverse reactions.

关 键 词：罗哌卡因 下肢手术 单侧 高龄患者 

分 类 号：R614.2[医药卫生—麻醉学]