期刊文献+
任意字段
题名或关键词
题名
关键词
文摘
作者
第一作者
机构
刊名
分类号
参考文献
作者简介
基金资助
栏目信息

小剂量左旋布比卡因与布比卡因复合芬太尼腰麻在高龄病人乙状结肠切除术的比较研究 被引量：4

原文传递
导出
摘要 目的比较研究小剂量左旋布比卡因与布比卡因复合芬太尼腰麻在高龄病人乙状结肠切除术的麻醉效果和血液动力学改变。方法 40例乙状结肠切除术病人,年龄80～95岁,ASAII～III级,随机分成两组各20例。腰硬联合穿刺,取L2～3一次注入蛛网膜下腔:A组左旋布比卡因3mg+芬太尼20μg,B组布比卡因3mg+芬太尼20μg,然后向上置入硬膜外导管4cm,2组术中均酌情注入0.375%左旋布比卡因4～6ml,维持阻滞平面T8～T6以上。观察感觉、运动阻滞和血液动力学变化。当SBP低于90mmHg或下降原SBP30%以上时,静脉注射麻黄碱5～6mg。HR低于55次/min或下降原HR20%以上时,静脉注射阿托品0.3～0.5mg。结果 40例麻醉皆满意,感觉阻滞2组比较无显著差异,运动阻滞A组较B组略差。2组腰麻后SBP、DSP和HR无明显改变(P均>0.05)。A组1例、B组2例静脉注射了麻黄碱,B组1例静脉注射了阿托品。结论小剂量左旋布比卡因与布比卡因复合芬太尼腰麻在高龄病人乙状结肠切除术中有满意的麻醉效果和稳定的血液动力学变化。小剂量左旋布比卡因较小剂量布比卡因更适合下腹部腰麻高龄病人手术。
作者 陆惠元 于礼 王寿世 王智玉 于建志
机构地区 山东省青岛大学医学院第二附属医院麻醉科 青岛市骨伤医院 山东省青岛大学医学院第二附属医院普外科
出处 《中国临床研究》 CAS 2012年第3期231-233,共3页 Chinese Journal of Clinical Research
关键词 腰麻 左旋布比卡因 布比卡因 芬太尼 血液动力学 乙状结肠切除术 高龄
分类号 R614.41 [医药卫生—麻醉学] R656.9 [医药卫生—外科学]
  • 相关文献

参考文献15

  • 1Ohmura S,Kawada M,Ohta T,et al.Systemic toxicity and resuscitation in bupivacaine-,levobupivacaine-,or ropivacaine-infused rats[J].Anesth Analg,2001,93(3):743-748.
  • 2Malinovsky JM,Renaud G,Le Corre P,et al.Intrathecal bupivacaine in humans:influence of volume and baricity of solutions[J].Anesthesiology,1999,91(5):1260-1266.
  • 3Axelsson K,Nydahl PA,Philipson L,et al.Motor and sensory blockade after epidural injection of mepivacaine,bupivacaine,and etidocaine—a double-blind study[J].Anesth Analy,1989,69(6):739-747.
  • 4Van Zundert A,Vaes L,Van der Aa P,et al.Motor blockade during epidural anesthesia[J].Anesth Analg,1986,65(4):333-336.
  • 5宋芬,顾小萍,马正良.腰-硬联合麻醉在老年患者腔内泌尿外科微创手术中的应用[J].临床麻醉学杂志,2010,26(3):227-228. 被引量：29
  • 6Valanne JV,Korhonen AM,Jokela RM,et al.Selective spinal anesthesia:a comparison of hyperbaric bupivacaine4mg versus6mg for outpatient knee arthroscopy[J].Anesth Analg,2001,93(6):1377-1379.
  • 7Varrassi G,Celleno D,Capogna G,et al.Ventilatory effects of subarachnoid fentanyl in the elderly[J].Anaesthesia,1992,47(7):558-562.
  • 8Stocks GM,Hallworth SP,Femando R,et al.Minimum local analgesic dose of intrathecal bupivacaine in labor and the effect of intrathecal fentany[lJ].Anesthesiology,2001,94(4):593-598.
  • 9Vercauteren MP,Hans G,De Decker K,et al.Levobupivacain combined with sufentanil and epinephrine for intrathecal labor analgesia:a comparison with racemic bupivacaine[J].Anesth Analg,2001,93(4):996-1000.
  • 10刘凤岐,傅世英,修春红,曲仁海,刘志襄.上胸段硬膜外阻滞对扩张型心肌病心腔及收缩功能的影响[J].中华麻醉学杂志,2001,21(3):178-179. 被引量：33

二级参考文献18

  • 1李荣胜,马武华,王心田,黎峰,庄新茂,高晓秋.妇科硬膜外左旋与消旋布比卡因运动阻滞效能比较[J].国际麻醉学与复苏杂志,2006,27(4):200-202. 被引量：9
  • 2陈家翠.前列腺增生症患者行尿道气化电切术的麻醉[J].临床麻醉学杂志,2007,23(5):430-430. 被引量：34
  • 3师树英 卫生部继续医学教育委员会.心力衰竭的病理生理及治疗.国家级继续医学教育项目系列教材选编（心血管病分册），第1版[M].长春:长春出版社,1999.253.
  • 4陆守曾.半数效量.见:郭祖超,主编.医用数理统计方法.第3版.北京:人民卫生出版社,1998.666-690.
  • 5Chang DH, Ladd LA, Wilson KA,et al. Tolerability of largedose intravenous levobupivaeaine in sheep. Anesth Analg, 2000,91 : 671-679.
  • 6Lacassie HJ, Columb MO, Lacassie HP, et al. The relative motor blocking potencies of epidural bupivacaine and ropivacaine in labor. Anesth Analg, 2002,95:204-208.
  • 7Lyons G, Columb M, Wilson RC, et al. Epidural pain relief in labour: potencies of levobupivacaine and racemic bupivacaine. Br J Anaesth, 1998,81 : 899-901.
  • 8Nydahl PA, Philipson L, Axelsson K, et al. Epidual anesthesia with 0. 5M bupivcaine: influence of age on sensory and motor blockade. Anesth Analg, 1991,73 : 780-786.
  • 9Mischa JG,Simon MD,Bemadette T,et al. The effects of age on neural blockade and hemodynamic changes after epidural anesthesia with ropivacaine. Anesth Analg, 2002, 94: 1325- 1330.
  • 10Li Y,Zhu S,Bao F,et al. The effects of age on the median effective concentration of ropivaeaine for motor blockade after epidural anesthesia with ropivacaine. Anesth Analg, 2006, 102: 1847-1850.

共引文献70

同被引文献43

  • 1张野.复合腰麻硬膜外麻醉[J].国外医学（麻醉学与复苏分册）,1996,17(4):210-212. 被引量：271
  • 2谢荣.麻醉学[M],3版,北京:科学出版社,1994:622-628.
  • 3Warner DO, Warner MA, Offord KP, et al. Airway obstruction and perioperative complications in smokers undergoing abdominalsurgery[ J]. Anesthesiology, 1999,90 (2) :372-379.
  • 4Cheney FW, Posner KL, Caplan RA. Adverse respiratory events infre- quently leading to malpractice suits. A closed claims analysis [ J ]. Anesthesiology, 1991,75(6) :932-939.
  • 5Bemards CM, Ulma GA Jr, Kopacz DJ. The meningeal permeabili- ty of R- and S-bupivacaine are not different: evidence that phar- macodynamic differences between the enantiomers are not the re- sult of differences in bioavailability [ J ]. Anesthesiology, 2000, 93 ( 3 ) : 896-897.
  • 6Kopacz D J, Allen HW, Thompson GE. A comparison of epidural levobupivacaine 0.75% with racemic bupivacaine for lower ab- dominal surgery [ J ]. Anesth Analg, 2000,90 ( 3 ) :642-648.
  • 7Ohmura S, Kawada M, Ohta T, et al. Systemic toxicity and resus- citation in bupivacaine-, levobupivacaine-, or ropivaeaine-infused rats[ J]. Anesth Analg,2001,93 (3) :743-748.
  • 8Suryaprakash S, Chakravarthy M, Gautam M, et al. Effect of tho- racic epidural anesthesia on oxygen delivery and utilization in car- diac surgical patients scheduled to undergo off-pump coronary ar- tery bypass surgery : a prospective study[ J ]. Ann Card Anaesth, 2011,14(3) :192-196.
  • 9Gruber EM, Tsehernko EM, Kritzinger M, et al. The effects of thoracic epidural analgesia with bupivacaine 0.25% on ventilatory mechanics in patients withsevere chronic obstructive pulmonary disease[ J]. Anesth Analg, 2001,92(4) : 1015-1019.
  • 10Bensehor FE, Vieira JE, Auler Jfiuior JO. Thoracic sympathetic block reduces respiratory system compliance [ J ]. Sao Paulo Med J, 2007,125 ( 1 ) :9-14.

引证文献4

二级引证文献19

中国临床研究
2012年 第3期

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部