摘要
目的观察低浓度轻比重罗哌卡因行单侧腰麻-硬膜外联合麻醉(CSEA)用于老年髋关节手术的可行性和安全性。方法择期髋关节手术90例,年龄65-93岁,ASAⅡ-Ⅲ级,随机分为两组:罗哌卡因组50例(R组),腰麻用药0.2%罗哌卡因8- 10mg,硬膜外注药为0.2%罗哌卡因;布比卡因组40例(B组),腰麻用药0.5%布比卡因8-10mg,硬膜外用药为0.375%布比卡因与1%利多卡因的混合液。术中持续监测NIBP、ECC和SpO2。以Bromage评分测定运动阻滞程度并记录。结果两组麻醉效果均能满足手术要求,术后元任何并发症。R组Bromage评分明显低于B组(P<0.01)。R组血流动力学较B组更平稳。结论低浓度、小剂世、轻比重罗哌卡因行单侧CSEA用于老年患者髋关节手术的麻醉不仅可行,而且安全,优于重比重布比卡因。
Objective To observe the efficacy and safety of unilateral combined spinal and epidural anesthesia (CSEA) with low concentration of hypobaric ropivocaine in senile hip joint surgery. Methods Ninety patients with ASA class Ⅱ-Ⅳ, 65 - 93 years old, undergoing elective hip joint surgery, were randomly divided into ropivocaine group (group R,n = 50) and bupicaine groups (group B,n = 40).Each patient in group R received spinally 8 - 10 mg of hypobaric ropivocaine and the anaesthesia was maintained with epidural administration of 0.2% ropivocaine. Each patient in group B received spinally 8 - 10 mg of hyperbaric bupicaine and the anaesthesia was maintained with epidural administration of mixture of 0.375% bupicaine and 1% lidcaine. BP, ECG, SpO2 were continually monitored during the operation, and the modified Bromage scale was adopted to measure motor block grade. Results Both groups meet the needs for surgery and all the patients recovered uneventfully from the anesthesia . The percentage of patients with 3 points of Bromage scale in group R was significantly lower than that in group B. And the hemodynamics in group R was more stable than that in group B. Conclusion The low concentration of hypobaric ropivocaine is effective for CSEA in senile hip joint surgery, and is safer than hyperbaric bupicaine.
出处
《华南国防医学杂志》
CAS
2005年第1期10-12,共3页
Military Medical Journal of South China
