轻比重0.5%罗哌卡因注药速度对高龄患者腰麻平面的影响  

Impact of 0.5% hypobaric ropivacaine with different injection rate on the anesthesia level for spinal anesthesia in elderly patients

作　　者：全立新[1] 

机构地区：[1]郑州市骨科医院麻醉科,郑州450052

出　　处：《医药论坛杂志》2015年第8期57-58,61,共3页Journal of Medical Forum

摘　　要：目的探讨轻比重0.5%罗哌卡因在不同注药速度下对高龄患者腰麻平面的影响。方法选择年龄≥75岁,择期行下肢及髋关节骨科手术手术患者90例,随机分为:A组30例(注药速度30 s),B组30例(注药速度40 s),C组30例(注药速度60 s)观察三组的阻滞平面、血压变化、麻醉效果、不良反应及需要追加局麻药的情况。结果三组患者给药后5、10、15 min的患侧阻滞平面情况比较,差异有统计学意义(P<0.05),A组最高阻滞平面T10以上的明显高于其他两组(P<0.05),C组最高阻滞平面T10以上0例;C组的低血压发生率低于A组和B组(P<0.05);三组均不需追加局部麻醉药。结论 0.5%轻比重罗哌卡因腰硬联合麻醉用于高龄患者,以60s的速度注药能获得低于T10的满意腰麻平面,血流动力学稳定,麻醉安全系数高。Objective To explore the impact of 0. 5% hypobaric ropivacaine with different injection rate on the anesthesia level for spinal anesthesia in elderly patients. Methods Ninety over seventy- five years old ASA gradeⅠ- Ⅲ patients undergoing lower extremity or hip arthroplasty surgery were randomly divided into the three groups（ n = 30） ： the group A（ injection rate： 30 s） 、the group B（ injection rate： 40s） and the group C（ injection rate： 60s）. The maximal pain block level,duration of anesthesia,anesthetic effect,hemodynamics,the requiring additional local anesthetics and adverse effect were observed. Results There was a statistical difference of anesthesia getting to the block level after administration of 5,10,15 minites in the three groups（ P〈0. 05）; the incidence rate of hypotension in the C group was lower than that in the A group（ P〈0. 05）,the incidence rate of heartbeat tachycardia,nausea and vomiting,chills were compared in the three groups and there was no statistical difference（ P〉0. 05）. Neither group needed additional local anesthetics. Maximal pain block level was the highest in Group A（ P〈0. 05）. Duration of anesthesia was higher in Group C than in Group A（ P〈0. 05）. Conclusion When applying 0. 5% hypobaric ropivacaine for spinal- epidural anesthesia in elderly patients,injection rate of 60 s can facilitate control of the anesthesia level with more stable circulation and better safety.

关 键 词：注药速度 轻比重0.5%罗哌卡因 腰麻平面 高龄 

分 类 号：R614[医药卫生—麻醉学]