用0.375%罗哌卡因对老年人工髋关节置换术患者进行麻醉的效果及安全性研究  

Efficacy and safety of anesthesia with 0.375% ropivacaine in elderly patients undergoing hip arthroplasty

作　　者：梁桂源 郑映纯 张理宾[1] LIANG Guiyuan;ZHENG Yingchun;ZHANG Libin(Guangzhou Panyu Hospital of Traditional Chinese Medicine,Guangzhou Guangdong 511400)

机构地区：[1]广州市番禺区中医院,广东广州511400

出　　处：《当代医药论丛》2023年第1期69-72,共4页

摘　　要：目的:探讨用0.375%罗哌卡因对老年人工髋关节置换术患者进行麻醉的效果及安全性。方法:选取2018年1月至2021年12月在广州市番禺区中医院行人工髋关节置换手术的老年患者90例,按随机抽样的方式分为A组和B组。两组患者术中均予腰硬联合麻醉,为A组采用0.375%罗哌卡因进行麻醉,为B组采用0.5%罗哌卡因进行麻醉,比较两组手术前、术中1h、术后2 h、术后24 h的平均动脉压(MAP)、心率(HR),术后2 h、24 h、48 h的VAS评分以及术后3天内发生尿潴留、恶心呕吐、头晕头痛的人数。结果:A组术中1h、术后2h的MAP、HR均高于B组,差异有统计学意义(P<0.05);在手术前、术后24h,两组的MAP、HR均无统计学差异(P>0.05)。术后2 h,A组的VAS评分高于B组,差异有统计学意义(P<0.05);术后24 h、术后48 h,A组的VAS评分均低于B组,差异有统计学意义(P<0.05)。A组发生尿潴留、头晕、头痛的人数明显少于B组,差异有统计学意义(P<0.05);两组发生恶心呕吐的人数无统计学意义(P>0.05)。结论:用0.375%罗哌卡因对老年人工髋关节置换术患者进行麻醉的效果较好,有利于其术后恢复,对其血流动力学影响小,可减轻其痛苦及麻醉不良反应。Objective:To investigate the efficacy and safety of 0.375%ropivacaine in anesthesia for elderly patients undergoing hip arthroplasty.Methods:A total of 90 elderly patients who underwent hip arthroplasty in Panyu Hospital of Traditional Chinese Medicine,Guangzhou from January 2018 to December 2021 were selected and randomly divided into group A and Group B.Both groups were given combined epidural anesthesia during the operation.Group A was anesthetized with 0.375%ropivacaine,and group B was anesthetized with 0.5%ropivacaine.The mean arterial pressure(MAP)and heart rate(HR)of the two groups were compared before surgery,1h during surgery,2 h after surgery,and 24 h after surgery.VAS scores at 2 h,24 h and 48 h after surgery and the number of patients with urinary retention,nausea,vomiting,dizziness and headache within 3 days after surgery.Results:MAP and HR of group A were higher than those of group B at 1 hour and 2 hours after operation,and the difference was statistically significant(P<0.05).There were no significant differences in MAP and HR between the two groups before and 24h after surgery(P>0.05).2 h after operation,VAS score of group A was higher than that of group B,the difference was statistically significant(P<0.05).24 h and 48 h after surgery,VAS score of group A was lower than that of group B,the difference was statistically significant(P<0.05).The number of patients with urinary retention,dizziness and headache in group A was significantly lower than that in group B,the difference was statistically significant(P<0.05).There was no statistical significance in the number of patients with naus ea and vomiting between the two groups(P>0.05).Conclusions:The anesthetic effect of 0.375%ropivacaine on elderly patients undergoing hip arthroplas ty is better,which is conducive to pos toperative recovery,has little influence on hemodynamics,and can allevia te pain and adverse anesthesia reactions.

关 键 词：0.375% 罗哌卡因 麻醉效果 术后恢复 腰硬联合麻醉 老年患者 

分 类 号：R614[医药卫生—麻醉学]