等比重布比卡因腰麻在骨科高龄患者下肢手术中的应用效果观察  

Observation on effect of lumbar anesthesia with isobaric bupivacaine in lower limb surgery of elderly orthopaedic patients

作　　者：朱宇[1] ZHU Yu(Department of Anesthesia,Siyang County Hospital of Traditional Chinese Medicine,Suqian 223700,China)

机构地区：[1]江苏省泗阳县中医院麻醉科,223700

出　　处：《中国实用医药》2023年第1期14-18,共5页China Practical Medicine

摘　　要：目的 探讨等比重布比卡因腰麻在骨科高龄患者下肢手术中的应用效果。方法 72例高龄下肢手术患者作为研究对象,均使用布比卡因腰麻,根据不同比重分为对照组及观察组,每组36例。对照组使用重比重布比卡因,观察组使用等比重布比卡因。比较两组麻醉优良率,麻醉指标(感觉阻滞起效时间、达最高阻滞平面时间、麻醉维持时间、Bromage分级、术中追加麻黄碱用量),血流动力学指标[平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_(2))],不良反应发生情况。结果 观察组麻醉优良率为100.00%,与对照组的97.22%比较,差异无统计学意义(P>0.05)。两组达最高阻滞平面时间、麻醉维持时间比较,差异无统计学意义(P>0.05);观察组感觉阻滞起效时间(2.31±0.73)min长于对照组的(1.52±0.64)min, Bromage分级(0.12±0.41)级低于对照组的(1.86±0.63)级,术中追加麻黄碱用量(5.41±1.78)mg少于对照组的(11.04±3.17)mg,差异具有统计学意义(P<0.05)。两组麻醉前,麻醉3、5、10 min的SpO2及麻醉前、麻醉10 min的MAP、HR比较,差异无统计学意义(P>0.05);观察组麻醉3、5 min的MAP高于对照组, HR低于对照组,差异具有统计学意义(P<0.05)。观察组的不良反应发生率13.89%低于对照组的47.22%,差异具有统计学意义(P<0.05)。结论 等比重布比卡因腰麻在骨科高龄患者下肢手术中的应用效果显著,与重比重布比卡因的腰麻效果、麻醉维持时间相当,且术中血流动力学稳定,术中追加麻黄碱用量更少,不良反应发生率更低,具有较好的麻醉效果及安全性。Objective To discuss the application effect of lumbar anesthesia with isobaric bupivacaine in lower limb surgery of elderly orthopaedic patients. Methods A total of 72 elderly patients with lower extremity surgery were studied, and all received bupivacaine for lumbar anesthesia, and they were divided into control and observation groups according to different specific gravity, with 36 cases in each group. In the control group, heavy bupivacaine was used, and in the observation group, isobaric bupivacaine was used. Both groups were compared in terms of excellent rate of anesthesia, anesthetic indexes(onset time of sensory block, time to the highest level of block, maintenance time of anesthesia, Bromage grading, intraoperative additional dosage of ephedrine),hemodynamic indexes [mean arterial pressure(MAP), heart rate(HR), blood oxygen saturation(SpO_(2))], and the occurrence of adverse reactions. Results The excellent rate of anesthesia in the observation group was 100.00%,which had no statistically significant difference compared with 97.22% in the control group(P>0.05). There was no statistically significant difference between the two groups in time to the highest level of block and maintenance time of anesthesia(P>0.05). In the observation group, the onset time of sensory block(2.31±0.73) min was longer than(1.52±0.64) min in the control group;the Bromage grading(0.12±0.41) grades was lower than(1.86±0.63) grades in the control group;the intraoperative additional dosage of ephedrine(5.41±1.78) mg was less than(11.04±3.17) mg in the control group;the differences were statistically significant(P<0.05). The SpO2before anesthesia, after 3, 5 and 10 min of anesthesia and MAP and HR before and after 10 min of anesthesia were compared between the two groups, and the differences were not statistically significant(P>0.05). After 3 and 5 min of anesthesia, the MAP in the observation group was higher than that in the control group, and the HR was lower than that in the control group, and the differences were statist

关 键 词：骨科 高龄 下肢手术 腰麻 布比卡因 等比重 应用效果 

分 类 号：R614[医药卫生—麻醉学]