摘要
目的观察小剂量芬太尼复合左布比卡因腰硬联合阻滞在下肢下腹部手术中的临床麻醉效果。方法选择下肢下腹部择期手术患者50例,随机分成A、B2组,每组25例。A组给予5mg/ml左布比卡因1.2ml复合芬太尼20μg联合麻醉,B组只给予芬太尼20μg。观察最高阻滞平面、麻醉持续时间、麻醉效果、生理指标变化、不良反应。结果 A组最高阻滞平面高于B组,差异有统计学意义(P<0.05);且A组到达最高阻滞平面时间为(5.2±3.4)min长于B组的(8.1±2.7)min,差异有统计学意义(P<0.05)。A组感觉阻滞维持时间及运动阻滞维持时间均长于B组,差异有统计学意义(P<0.05)。2组手术开始时血压均低于麻醉前,且A组注药后30min收缩压也低于麻醉前,差异均有统计学意义(P<0.05)。A组手术开始时及注药后30min收缩压和手术开始时舒张压均低于B组,差异有统计学意义(P<0.05)。2组心动过缓、恶心呕吐及腰麻后头痛发生率比较,差异均无统计学意义(P>0.05)。结论在下肢下腹部手术中应用小剂量芬太尼复合左布比卡因腰硬联合阻滞是有效、安全的。
Objective To evaluate the clinical anesthetic effect of small doses fentanyl and levobupivacaine for combined spinal-epidural anesthesia in the lower abdominal and extremities surgery.Methods 50 cases patients were randomly divided into group A and group B,25 cases of each.Group A was given levobupivacaine 1.2ml,5mg/ml anesthesia combined with fentanyl 20μg;Group B only received fentanyl 20μg.Observed the highest block level,duration of anesthesia,anesthesia,physiology,adverse reaction.Results The highest block level of group A was higher than that of group B,the difference was statistically significant（P0.05）;Block and the plane reaches a maximum time of group B[（5.2±3.4）min] was shorter than that of group A[（8.1±2.7）min],the difference was statistically significant（P0.05）.Duration of sensory block and motor block duration of group A were shorter than group B,the difference was statistically significant（P0.05）.Blood pressure of the beginning of operation of 2 groups were lower than that before anesthesia and the systolic blood pressure after injection 30min of group A were also lower than that before anesthesia,the differences were statistically significant（P0.05）.Beginning of operation and 30min after the injection when the systolic and diastolic blood pressure of group A were lower than the beginning of operation B group （P0.05）.Conclusion It is effective,safe that small doses fentanyl and levobupivacaine for combined spinal-epidural anesthesia in the lower abdominal and extremities surgery.
出处
《临床合理用药杂志》
2010年第16期34-35,共2页
Chinese Journal of Clinical Rational Drug Use
关键词
左布比卡因
芬太尼
腰硬联合麻醉
Levobupivacaine
Fentanyl
Combined spinal-epidural anesthesia
