不同剂量布比卡因在老年髋关节置换术腰硬联合麻醉中的应用效果分析  

Analysis of Application Effect of Different Doses of Bupivacaine in Combined Spinal and Epidural Anesthesia for Elderly Hip Replacement Surgery

作　　者：熊启文 Xiong Qiwen(Department of Anesthesiology,Suining County Suihe Orthopedic Hospital,Xuzhou 221200,Jiangsu Province,China)

机构地区：[1]徐州市睢宁县睢和骨科医院麻醉科,江苏徐州221200

出　　处：《中国社区医师》2025年第4期27-29,共3页Chinese Community Doctors

摘　　要：目的:分析不同剂量布比卡因在老年髋关节置换术腰硬联合麻醉中的应用效果。方法:选取2022年8月—2024年8月于徐州市睢宁县睢和骨科医院行腰硬联合麻醉髋关节置换术的患者72例作为研究对象,以随机数字表法分为对照组和观察组,各36例。对照组在腰硬联合麻醉中给予常规剂量布比卡因,观察组在腰硬联合麻醉中给予小剂量布比卡因。比较两组麻醉效果。结果:两组上升至最高阻滞平面时间、感觉阻滞起效时间、运动阻滞起效时间比较,无统计学差异(P>0.05);观察组感觉阻滞恢复时间、运动阻滞恢复时间短于对照组(P<0.05)。两组麻醉总优良率比较,无统计学差异(P>0.05)。术后4 h,观察组疼痛评分高于对照组(P<0.001);术后8、12、24 h,两组疼痛评分低于术后4 h,但两组疼痛评分比较,无统计学差异(P>0.05)。观察组不良反应总发生率低于对照组(P=0.047)。结论:常规剂量和小剂量布比卡因在老年腰硬联合麻醉髋关节置换术中均可获得较好的麻醉效果,小剂量布比卡因对术后4 h疼痛缓解效果不如常规剂量布比卡因,但小剂量布比卡因感觉阻滞、运动阻滞恢复快,不良反应少。Objective:The analyze the application effect of different doses of bupivacaine in combined spinal and epidural anes⁃thesia for elderly hip replacement surgery.Methods:A total of 72 patients who underwent combined spinal and epidural anesthesia for hip arthroplasty in Suining County Suihe Orthopedic Hospital of Xuzhou City from August 2022 to August 2024 were selected as the study subjects.They were divided into control group and observation group according to random number table method,with 36 cases in each group.The control group was given conventional-dose bupivacaine in combined spinal and epidural anesthesia,and the observation group was given small-dose bupivacaine in combined spinal and epidural anesthesia.The anesthetic effect was compared between the two groups.Results:There was no statistically significant difference in the time to reach the highest block plane,the onset time of sensory block,and the onset time of motor block between the two groups(P>0.05).The recovery time of sensory block and recovery time of motor block in the observation group were shorter than those in the control group(P<0.05).There was no statistically significant difference in the total excellent rate of anesthesia between the two groups(P>0.05).At 4 h af⁃ter surgery,the pain scores in the observation group were higher than those in the control group(P<0.001).At 8,12 and 24 h after surgery,the pain scores in the two groups were lower than those at 4 h after surgery,but there was no statistical difference in the pain scores between the two groups(P>0.05).The total incidence of adverse reactions in the observation group was lower than that in the control group(P=0.047).Conclusion:Both conventional-dose and low-dose bupivacaine can achieve better anesthetic ef⁃fect in combined spinal and epidural anesthesia for elderly hip replacement surgery,and the effect of low-dose bupivacaine on pain relief at 4 h after surgery is not as good as that of conventional-dose bupivacaine,but low-dose bupivacaine induces the faster recovery of

关 键 词：髋关节置换术 老年 腰硬联合麻醉 布比卡因 

分 类 号：R614.4[医药卫生—麻醉学]