摘要
目的研究轻比重布比卡因单侧连续腰麻（CSA）用于高龄患者髋关节置换术的安全性和有效性。方法择期髋关节置换手术患者40例，年龄78～92岁，ASAⅡ～Ⅲ级，随机分为CSA组和连续硬膜外麻醉组（CEA组），每组20例。观察2组麻醉前（T0，基础值）和麻醉后5min（T1）、10min（T2）、15min（T3）、30min（T4）、1h（T5）、术毕（T6）患者循环、呼吸功能的变化，比较2组感觉阻滞平面、运动阻滞程度、不良反应。结果与T0比较，CSA组平均动脉压（MAP）在T1～T6降低（P〈0．05），脉搏血氧饱和度（SpO2）升高（P〈0．05或0．01）；CEA组MAP在T3～T6降低（P〈0．05或0．01）。与CEA组比较，CSA组MAP在T3升高（P〈0．05），SpO。2在T1～T6升高（P〈0．05或0．01）。CSA组患侧感觉阻滞平面较CEA组低，运动阻滞程度明显高于CEA组（P〈0．01）。CSA组术中低血压发生率及术后恶心、呕吐发生率明显低于CEA组（P〈0．05）。结论单侧CSA显效快，运动神经阻滞完善，血液动力学平稳，不良反应少，用于高龄患者髋关节置换手术是安全的。
Objective To explore the security and feasibility of using unilateral continuous spinal anesthesia （CSA） with hypoharic hupivacaine in elderly patients with hip replacement. Methods Forty ASA Ⅱ - Ⅲ patients aged 78 - 92 years were randomly divided into CSA groups AND continuous epidural anesthesia（CEA） group （n = 20 ）, The changes of circulation and respiratory function were observed before the anesthesia （To, the basic figure） and after the anesthesia at the time of 5 minutes （ T1 ）, 10 minutes （ T2 ）, 15 minutes （ T3 ）, 30 minutes （ T4 ）, 1 hour（ T5 ） , and the operation was completed （ T6 ）. Sensory block, degree of motor blockade and adverse effect were observed and compared. Results Compared with To, mean arterial pressure （MAP） was lower （ P 〈 0.05 ）, and blood oxygen saturation （ SpO2 ） was higher at T1 - T6 in C SA group （ P 〈 0. 05 or 0.01 ）, MAP was lower at T3 -T6 in CEA group（P 〈0.05 or 0.01 ）. Compared with CEA group,MAP was higher at T3 （P 〈0.05） , SpO2 was higher at T1 - T6 in CSA group（ P 〈 0.05 or 0.01 ）. The level of sensory block in CSA group was relatively lower than that in CEA group while the degree of motor nerve block was significantly higher than that in the CEA group （ P 〈 0.01 ）. The incidences of hypotension, nausea and vomiting after operation were lower in CSA group than those in CEA group （ P 〈 0.05 ）. Conclusion Unilateral CSA has quick effect,consummate motor nerve block, steady haemodynamics and fewer adverse effect, Using unilateral CSA in elderly patients with hip replacement is safe.
出处
《新乡医学院学报》
CAS
2008年第5期493-495,共3页
Journal of Xinxiang Medical University
关键词
布比卡因
连续腰麻
髋关节置换术
bupivacaine
continuous spinal anesthesia
hip replacement
