摘要
目的评价3%氯普鲁卡因用于老年患者泌尿外科手术硬膜外阻滞的效果。方法ASAⅠ～Ⅱ级无脊柱畸形的泌尿外科手术老年患者120例,随机分为两组,Ⅰ组为氯普鲁卡因组,硬膜外麻醉所用的局麻药为3%氯普鲁卡因,Ⅱ组为利多卡因组,所用局麻药为2%利多卡因,根据泌尿外科手术部位的需要,选择L2～3间隙行硬膜外穿刺,向头侧置管,试验量为3ml,5min后追加至麻醉平面满足手术要求。记录镇痛起效时间、运动阻滞起效时间、镇痛持续时间、运动阻滞持续时间,采用针刺法测定痛觉消失最高平面,采用改良Bromare分级评价下肢运动神经阻滞最大程度。结果两组老年泌尿外科手术患者年龄、体重、性别差异无统计学意义(均P>0.05)。Ⅰ组镇痛起效、运动阻滞起效明显快于Ⅱ组,运动阻滞持续时间显著短于Ⅱ组(均P<0.05),两组痛觉消失最高平面、运动阻滞最大程度、镇痛持续时间比较差异无统计学意义(均P>0.05)。Ⅰ组对循环功能无明显影响,Ⅱ组有一过性降低收缩压(SBP)的作用(P<0.05)。结论3%氯普鲁卡因用于老年患者泌尿外科手术硬膜外阻滞具有起效快,镇痛完善,肌松满意,血流动力学稳定等优点,可作为老年患者泌尿外科手术硬膜外阻滞的首选局麻药。
Objective To evaluate the efficacy of 3% chloroprocaine for the aged patients undergoing urinary surgery in epidural anesthesia. Methods 120 ASA Ⅰ -Ⅱ aged patients without vertebral column deformity undergoing urinary surgery were randomly divided into two groups： group Ⅰ （3% chloroproeaine group） and group Ⅱ （2% lidocaine group）. After a 3 ml test dose was injected into L2-3 epidural space, another dose of local anesthetic was given until anesthesia level reached the ideal effect. Onset time of pain free and motor blockage, duration of pain free and motor blockage were recorded. Results There was no significant difference in age, weight, sex between groups Ⅰ and Ⅱ （P〉0. 05）. Onset time of pain free and motor blockage in groupⅠ was significantly quicker than that in group Ⅱ （P〈0.05）. Duration of motor blockage in group Ⅰ was markedly shorter than in group Ⅱ （P〈0.05）. Circulation was not influenced in group Ⅰ . Transient reduction of SBP occurred in group Ⅱ （P〉0.05）. Conclusion 3% chloroprocaine can be safely and efficiently used to aged patients undergoing urinary surgery in epidural anesthesia.
出处
《华中科技大学学报（医学版）》
CAS
CSCD
北大核心
2009年第3期398-400,416,共4页
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong
