摘要
目的观察甲磺酸罗哌卡因在老年人下腹部手术麻醉中的应用效果及安全性。方法90例下腹部手术的老年患者（阑尾切除术及腹股沟斜疝修补术各45例），按住院单双号随机分成两组：A组45例、B组45例，A组在蛛网膜下腔用：0．894％甲磺酸罗哌卡因1．5ml＋10％葡萄糖1ml进行麻醉，B组采用0．75％盐酸布比卡因1．5ml＋10％葡萄糖1ml于蛛网膜下腔进行麻醉，比较两组麻醉起效时间、麻醉平面固定时间、麻醉效果、下肢运动功能及血压、心率、动脉血氧饱和度、术中、术后相关并发症发生等情况。结果A组麻醉后收缩压下降率8．9％、心率减慢率为6．7％、术中恶心呕吐不良反应发生率6．7％，与B组的28．9％；20％；17．8％相比较差异均有统计学意义（均P〈0．05），A组麻醉起效时间（52．0±21．5）s、最高平面出现时间（13．2±3．3）min长于B组（41．2±18．2）s；（11．3±3．6）min（P〈0．01），两组术中血氧饱和度下降例数均为2例、Bromage评分分别为（2．3±0．7）与（2．2±0．5）分及术后头痛发生率0％与2．2％差异无统计学意义（P〉0．05）。结论罗哌卡因用于老年人下腹部手术腰麻．硬膜外联合麻醉是安全有效的。
Objective To investigate the effect and safety of Ropivacaine mesylate in combined spinal-epiduaral anesthesia of hypogastric operations of eider patient. Methods 90 cases patients scheduled for the lower abdominal surgery were randomly divided into two groups（ appendectomy and Oblique inguinal hernia neoplasty）, group Ropivacaine mesylate （ group A, n = 45 ）, group upivacaine hydrochloride （ group B, n = 45 ）, A, B groups, punctures were selected between L2 - L3 , Hyperbaric solution of Ropivacaine mesylate were injected intrathecaly respectively in two groups. （compounding：group A：0. 894% Ropivacaine hydrochloride 1.5ml ± 10% Glucose lml） and group B： （0. 75% Bupivacaine hydrochloride 1.5ml ＋ 10% Glucose 1ml）. The two groups after the subarachnoid medication Indwelling catheter to the cephalic in the epidural space. The time of anaesthetic emergence, maintainance, and the anaesthetic level were observed;the analgetic effect was assessed;movement signs of the lower limbs were observed; blood pressure,respiration and SpO2, postoperative complications were observed. Results There was apparent differentiation between group A which Systolic blood pressure declined 8.9%, heart rate decreased 6. 7%, intraoperative nausea came up to 6.7% after anaesthesia and group B which was 28.9% ,20%, 17. 8%, respectively（ P 〈 0. 05 ）. The effective time of anaesthetic emergence was（52. 0 ±21.5） s and （ 13.2 ±3.3） min in group A longer than group B was （41.2 ± 18. 2） s and （ 11.3 ± 3.6） min （ P 〈 0.01 ）. There was no difference in SpO2, Bromage Score about extreme movement blockage degree （ 2. 3 ± 0. 7 ; 2.2 ± 0. 5 ）, the incidence of postoprative headache （ 0% ; 2. 2% ） between the group A and group B （P 〉 0. 05）. Conclusion Ropivacaine mesylate can be used effectively and safetly in combined spinal-epiduaral anesthesia applied in hypogastric operations of elder patients,for cardiovascular stability is superior to bupivacaine.
出处
《中国基层医药》
CAS
2009年第8期1359-1360,共2页
Chinese Journal of Primary Medicine and Pharmacy
关键词
麻醉
硬膜外
罗哌卡因
布比卡因
老年人
Anesthesia, epiduaral
Ropivacaine mesylate
Bupivacaine
Aged
