摘要
目的观察布比卡因复合小剂量舒芬太尼用于老年患者下腹部或下肢手术腰麻的麻醉效果。方法择期行下腹部或下肢手术的老年患者60例,ASAⅡ或Ⅲ级,年龄70～90岁,体重50～80kg。随机分为2组(n=30):L组(单纯布比卡因7.5mg)和LS组(布比卡因4.5mg复合舒芬太尼5μg)。蛛网膜下腔穿刺成功后,注入含糖浓度为6.7%的重比重混合局麻药1.5mL,注入时间20s。记录感觉阻滞起效时间、感觉阻滞最高平面、感觉阻滞持续时间、Bramage分级及副作用。结果2组患者年龄、身高、体重、ASA分级比、手术时间等比较差异无显著性(P>0.05)。与L组比较,LS组患者感觉阻滞起效时间缩短,感觉阻滞持续时间延长(P<0.01)。L组运动阻滞程度强于LS组(P<0.01)。L组出现低血压、恶心呕吐的患者多于LS组(P<0.01),而LS组有2例患者出现一过性轻微的瘙痒(P<0.01)。结论小剂量布比卡因复合5μg舒芬太尼腰麻持续镇痛时间延长,能满足老年患者下腹部或下肢手术的麻醉需要,且副作用减少,可增加手术的安全性。
【Objective】To evaluate the anesthesia effect and side-effect of intrathecal Bupivacaine combination with low-dose Sufentanil in elder patients. 【Method】60 elder patients,ASA Ⅱ～Ⅲ,at age 70～90,were randomly allocated into two groups n =60：group L （only Bupivacaine 7.5 mg）,group LS （Bupivacaine 4.5 mg with Sufentani 15 μg）. All patients received 6.7% glucose hyperbaric mix-solusion to a total amount of 1.5 ml for spinal anesthesia. Data obtained from this study included the time to onset,the highest level and duration of sensory block,and side effects were also recorded.【Results】The demographic data including age,height,body weight,ASA physical status were not significantly different between the two groups. Compared with group L,group LS has represented the rapid onset and the prolonged duration. The mean plane of motor block was higher in group L than in group LS. The incidence of hypotension and nausea were higher in group L than in group LS.【Conclusions】The addition of sufentanil 5μg to bupivacaine 4.5 mg provides adequate analgesia with fewer side-effects in elderly patients when compared with bupivacaine 7.5 mg alone during spinal anesthesia.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2010年第1期136-138,共3页
China Journal of Modern Medicine
关键词
布比卡因
舒芬太尼
腰麻
Bupivacaine
Sufentanil
intrathecal
