罗哌卡因复合舒芬太尼蛛网膜下腔麻醉在高龄患者髋关节置换术中的应用  

The application of ropivacaine with sufentanil for subarachnoid anesthesia in elderly patients undergoing hip arthroplasty

作　　者：杨同文[1] 廖春英[1] 王强[2,3] YANG Tong-wen;LIAO Chun-ying;WANG Qiang(Department of Anesthesiology,Beijing Huairou Hospital of Traditional Chinese Medicine,Beijing 101400,China;Department of Anesthesiology,Beijing Boai Hospital,China Rehabilitation Research Center,Beijing 100068,China;Rehabilitation College,Capital Medical University,Beijing 100068,China)

机构地区：[1]北京市怀柔区中医医院麻醉科,北京101400 [2]中国康复研究中心北京博爱医院麻醉科,北京100068 [3]首都医科大学康复医学院,北京100068

出　　处：《临床和实验医学杂志》2018年第8期887-890,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的观察罗哌卡因复合舒芬太尼蛛网膜下腔麻醉在高龄患者髋关节置换术中的应用效果。方法前瞻性选取2014年3月至2017年6月北京市怀柔区中医医院50例拟在蛛网膜下腔麻醉下行髋关节置换术的高龄患者随机分成罗哌卡因复合舒芬太尼组(RS组,n=25)和单纯罗哌卡因组(R组,n=25)。选择L2~L3间隙穿刺。腰穿成功后,RS组蛛网膜下腔内注射罗哌卡因12 mg及舒芬太尼2.5μg(生理盐水稀释至3 ml),R组蛛网膜下腔内注射罗哌卡因12 mg(生理盐水稀释至3 ml),注射时间60 s。比较两组患者的感觉阻滞时间、运动阻滞评分、术中镇痛评分、麻醉肌松评分、感觉恢复时间、运动恢复时间、术后镇痛评分、满意度评分(包括患者满意评分和术者满意评分、不良事件(包括低血压、心动过缓、恶心呕吐、寒战)。结果 RS组的感觉阻滞时间明显短于R组(P<0.05)。RS组的术中镇痛评分明显高于R组(P<0.05)。RS组的术后镇痛评分明显高于R组(P<0.05)。RS组的患者满意评分明显高于R组(P<0.05)。两组的运动阻滞评分、麻醉肌松评分、感觉恢复时间、运动恢复时间、术者满意评分及不良事件发生率无显著性差异(P>0.05)。结论罗哌卡因复合舒芬太尼蛛网膜下腔麻醉能安全、有效地应用于高龄患者髋关节置换术。Objective To observe the effect of ropivacaine with sufentanil for subarachnoid anesthesia in elderly patients undergoing hip arthroplasty.Methods Fifty elderly patients undergoing hip arthroplasty in Beijing Huairou Hospital of Traditional Chinese Medicine during March 2014 to June 2017 were prospectively chosen and randomly assigned to group RS(n=25)and group R(n=25).The puncture site at L 2-3 was chosen for subarachnoid anesthesia.After successful puncture,ropivacaine 12mg and sufentani l2.5μg in 0.9%sodium chloride 3 ml were injected into subarachnoid space in group RS and ropivacaine12mg alone in 0.9%sodium chloride 3 ml was injected into subarachnoid space of patients in group R.The duration of injection was 60 seconds for all patients.Items including sensory block onset time(SBOT),motion block scale(MBS),intraoperative analgesia scale(IAS),muscle relaxing scale(MRS),sensory recovery time(SRT),motion recovery time(MRT),postoperative analgesia scale(PAS),patient satisfaction scale(PSS),surgeon satisfaction scale(SSS),and side effects such as intraoperative hypotension,bradycardia,nausea or vomiting,and shiver were observed.Results SBOT in group RS was significantly shorter than that of group R(P<0.05).IAS in group RS was significantly higher than that in group R(P<0.05).PAS in group RS was significantly higher than that of group R(P<0.05).PSS in group RS was significantly higher than that of group R(P<0.05).There was no difference in MBS,MRS,SRT,MRT,SSS and side effects between these two groups(P>0.05).Conclusion The application of ropivacaine combined with sufentanil is safe and effective for subarachnoid anesthesia in elderly patients undergoing hip arthroplasty.

关 键 词：高龄患者 髋关节置换术 蛛网膜下腔麻醉 罗哌卡因 舒芬太尼 

分 类 号：R614[医药卫生—麻醉学]