轻比重与重比重布比卡因腰-硬联合麻醉用于老年患者下肢手术效果和安全性研究  

The safety and effect of hypobaric and hyperbaric bupivacaine in combined spinal-epidural anesthesia for elderly patients with lower limb surgery

作　　者：吴铖炜 

机构地区：[1]丽水市中心医院麻醉科,浙江省丽水323000

出　　处：《中国基层医药》2017年第22期3377-3381,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 比较轻比重与重比重布比卡因腰-硬联合麻醉用于老年患者下肢手术的效果及安全性.方法 选择行下肢手术的老年患者72例,采用随机数字表法分为对照组和观察组,每组36例,分别行轻比重与重比重布比卡因腰-硬联合麻醉,对比两组患者手术过程中麻醉效果及血流动力学相关指标,并记录术中及术后麻醉相关不良反应发生情况.结果 观察组镇静效果优良率为88.91（32/36）,对照组为91.67%（33/35）,两组差异无统计学意义（χ2=0.16,P=0.69）;观察组患者手术过程中平均动脉压波动情况小于对照组;观察组不良反应发生率,包括腰酸痛、尿潴留、神经症状均明显低于对照组,差异均有统计学意义（均P〈0.05）.结论 轻比重布比卡因腰-硬联合麻醉镇痛效果优良,对生命体征相关指标影响较小,术后循环系统稳定,手术安全性好,是老年患者下肢手术中具有一定优越性的麻醉方法.Objective To compare the efficacy and safety of hypobaric and hyperbaric bupivacaine in combined spinal - epidural anesthesia for elderly patients with lower extremity surgery. Methods A total of 72 patients underwent lower limb surgery were randomly divided into control group and observation group according to the digital table,36 patients in each group. The patients were given hypobaric or hyperbaric bupivacaine in combined spinal-epidural anesthesia. The anesthesia effect during surgery and hemodynamics related indicators were compared between the two groups,and the intraoperative and postoperative anesthesia-related adverse reactions were recorded. Results The excellent and good rate of sedation in the observation group was 88. 91% （32/36）,which in the control group was 91. 67% （33/35）,the difference was not statistically significant （χ2 =0. 16,P=0. 69）. The incidence rates of adverse events of the observation group,including back pain,urinary retention and neurological symptoms were significantly lower than those of the control group （all P〈0. 05）. Conclusion The effect of hypobaric bupivacaine is excellent,the effect of hemodynamics is small,the postoperative circulatory system is relatively stable,the operation safety is better,it is superior to the middle and elderly patients with lower limb surgery anesthesia.

关 键 词：麻醉 硬膜外 老年人 安全 

分 类 号：R614[医药卫生—麻醉学]