摘要
目的观察小剂量轻比重罗哌卡因腰-硬联合阻滞在老年人下肢手术的麻醉效果和安全性。方法 60例单侧下肢手术老年病人,ASAⅡ～Ⅲ级,随机分为R1(0.5%罗哌卡因10mg)、R2(0.4%罗哌卡因8mg)、R3(0.3%罗哌卡因5～7mg)3组,取患肢上方侧卧位L3-4间隙穿刺,蛛网膜下腔注药。观察麻醉效果、麻醉后血流动力学变化、麻醉不良反应。结果 3组均成功单侧阻滞,镇痛效果满意。感觉阻滞起效时间、感觉阻滞最大平面差异无统计学意义;感觉阻滞消退时间R2、R3组明显短于R1组(P<0.01),R2、R3两组肌松弱于R1组但不影响手术进行。血压下降幅度R3组显著小于R1组(P<0.01)。结论小剂量(5～7mg)轻比重罗哌卡因腰-硬联合单侧阻滞更适用于老年下肢手术麻醉。
Objective To observe the clinical efficacy and safety of combined spinal-epidural anesthesia with light specific gravity of low dose ropivacaine in the aged patients undergoing lower limb surgery.Methods Sixty aged patients with unilateral lower extremity surgery,ASA II～III,were randomly divided into three groups：group R1（0.5% ropivacaine 10 mg）,group R2（0.4% ropivacaine 8 mg） and group R3 （0.3% ropivacaine 5～7 mg）.The anesthetic efficacy,hemodynamic changes and side effects were observed.Results Each group produced perfect quality of anesthesia.The blockade of single leg occurred in all patients.There was no significant difference in onset time and maximum level of sensory block among the three groups.Regression time of sensory block in group R2 and R3 were less than those in group R1 （P0.01）.The effect of muscle relaxation of the groups R3 was inferior to that of the group R1and the safety were not affected.The reduction of BP of group R3 were less than that of the group R1 （P0.01）.Conclusion Combined spinal-epidural anesthesia with light specific gravity of low dose ropivacaine （5 ～7 mg）is suitable for aged patients undergoing lower limb surgery.
出处
《中国疗养医学》
2010年第7期633-635,共3页
Chinese Journal of Convalescent Medicine
关键词
罗哌卡因
小剂量
轻比重
腰-硬联合阻滞
老年人
下肢手术
Ropivacaine
Low dose
Light specific gravity
Combined spinal-epidural anesthesia
Aged
Lower limb surgery
