硬膜外持续泵入利多卡因在老年人股骨头置换术中的应用研究  

Application of continuous pumping of lidocaine for epidural anesthesia in the elderly with femoral head replacement

作　　者：罗辉[1] 刘海燕[1] 

机构地区：[1]东风汽车公司茅箭医院麻醉科,湖北十堰442012

出　　处：《中国民康医学》2015年第14期1-3,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:观察硬膜外持续泵入利多卡因在老年人股骨头置换术中的麻醉效果。方法:选择股骨头置换术老年患者40例,随机分成持续泵注组和分次推注组,每组各20例。持续泵注组患者用微量注射泵持续向硬膜外腔泵注局麻药,分次推注组患者则采用传统分次给药方式;分别测定麻醉前及硬膜外给药后5 min、10 min、20 min、30 min、1 h各时点的血压和HR、Sp O2,同时评定镇痛起效时间、麻醉平面、麻醉效果、肌松质量、用药总量。结果:持续泵注组患者的血压(BP)、心率(HR)波动显著降低,用药总量下降,与分次推注组比较差异有统计学意义(P<0.05),两组患者间麻醉阻滞平面、镇痛效果、Sp O2比较,差异无统计学意义(P>0.05)。结论:硬膜外微泵持续泵入给药方法用于老年人股骨头置换术可以达到间断分次给药法同样的麻醉效果,血压、心率平稳,用药量少,是一种安全的适合老年人生理特点的给药方法。Objective: To observe anesthesia effects of epidural continuous pumping of lidocaine in the elderly with femoral head replacement. Methods:40 elderly patients with femoral head replacement were randomly divided into continuous pump injection group ( C group) and divided bolus injection group ( F group) , 20 cases in each group. Group C used trace injection pump to deliver local anesthetics to epidural cavity, while F group was given the traditional divided administration method. Blood pressure, HR, and SpO2 were determined before anesthesia and 5, 10, 20, 30min and 1h after administration. At the same time, the analgesic onset time, anesthesia plane, anesthesia effects, muscle relaxation quality, and total dose were evaluated. Results:BP and HR fluctuation of C group were significantly reduced, and total dose decreased compared with those of F group, and the differences were statistically significant (P<0. 05). The differences of anesthetic plane, analgesic effect and SpO2 between the two groups were not statistical signif-icant (P>0. 05). Conclusions:For the elderly patients with femoral head replacement, the epidural continuous pumping of anesthet-ics has the same anesthesia effect with the traditional divided administration method, can stabilize BP and HR with less dose, and is safe and suitable for the old people's physiological characteristics.

关 键 词：硬膜外 高龄 持续泵入 股骨头置换 利多卡因 

分 类 号：R681.8[医药卫生—骨科学]