等效剂量罗哌卡因与布比卡因在老年下肢手术麻醉中对患者运动阻滞起效时间和恢复时间及平均动脉压与心率的影响  

Effect of equivalent dose ropivacaine and bupivacaine on onset time of motor block,recovery time,mean arterial pressure and heart rate in elderly patients undergoing lower limb surgery anesthesia

作　　者：饶胜雷 李承进 RAO Shengei;LI Chengjin(Department of Anesthesiology,Huarunfeng Mining General Hospital,Fengcheng,Jiangxi,331141,China)

机构地区：[1]华润丰矿总医院麻醉科,江西丰城331141

出　　处：《当代医学》2023年第3期61-64,共4页Contemporary Medicine

基　　金：江西省卫生计生委科技计划项目(20165416)。

摘　　要：目的探讨等效剂量罗哌卡因与布比卡因在老年下肢手术麻醉中对患者运动阻滞起效时间、恢复时间、平均动脉压(MAP)与心率(HR)的影响。方法选取2018年1月至2020年6月本院收治的80例老年下肢手术患者作为研究对象,按照随机数字表法分为两组,每组40例。两组均给予腰硬联合麻醉,麻醉药物分别选择等效剂量罗哌卡因(观察组)与布比卡因(对照组)。比较两组运动阻滞起效时间、镇痛起效时间、运动恢复时间、并发症发生率及不同时点MAP与HR。结果观察组运动阻滞起效时间、镇痛起效时间、运动恢复时间均短于对照组,差异有统计学意义(P<0.05)。两组MAP与HR组间、交互比较差异有统计学意义(P<0.05);两组MAP、HR时间比较差异无统计学意义;T0时,两组MAP、HR比较差异无统计学意义;T1、T2时,观察组MAP、HR与T0时比较差异无统计学意义,对照组MAP、HR均低于T0时与观察组,差异有统计学意义(P<0.05)。观察组并发症发生率为2.50%,低于对照组的20.00%,差异有统计学意义(P<0.05)。结论罗哌卡因应用于老年下肢手术麻醉中效果更好,不仅镇痛起效快,运动恢复快,且安全性更高,对患者的HR与MAP影响更小,值得临床推广应用。Objective To investigate the effects of equivalent dose ropivacaine and bupivacaine on onset time,recovery time,mean arterial pressure(MAP)and heart rate(HR)in elderly patients undergoing lower limb surgery anesthesia.Methods A total of 80 elderly patients with lower limb surgery admitted to our hospital from January 2018 to June 2020 were selected as the research subjects,and they were divided into two groups according to the random number table method,with 40 cases in each group.Both groups were given combined spinal-epidural anesthesia,and the anesthetic drugs were selected as equivalent doses ropivacaine(observation group)and bupivacaine(control group),the onset time of motor block,onset time of analgesia,recovery time of movement,complication rate,MAP and HR at different time points were compared between the two groups.Results The onset time of motor block,the onset time of analgesia and the recovery time of movement in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).There were significant differences in MAP and HR between the groups and interaction(P<0.05);there was no significant difference in MAP and HR time between the two groups;at T0,there was no significant difference in MAP and HR between the two groups;at T1 and T2,there was no significant difference in MAP and HR between the observation group and T0,the MAP and HR of the control group were lower than those of the observation group at T0,and the differences were statistically significant(P<0.05).The complication rate of the observation group was 2.50%,which was lower than 20.00%of the control group,and the difference was statistically significant(P<0.05).Conclusion Ropivacaine is more effective in anesthesia for lower limb surgery in the elderly,it not only has fast analgesic effect,fast recovery of movement,but also has higher safety,it has less effect on HR and MAPof patients,which is worthy of clinical promotion and application.

关 键 词：老年下肢手术 等效剂量 罗哌卡因 布比卡因 起效时间 平均动脉压 心率 

分 类 号：R614[医药卫生—麻醉学]