摘要
目的评价轻比重布比卡因腰硬联合麻醉在老年髋关节置换术中的应用效果。方法回顾性分析采用轻比重布比卡因腰硬联合麻醉进行髋关节置换手术的47例老年患者临床资料,记录患者麻醉起效时间、运动阻滞起效时间、麻醉平面固定时间、最大Bromage评分等;记录患者并发症如低血压、心动过缓、呼吸抑制、恶心呕吐、尿潴留等发生情况;常规血流动力学监测包括注药前(T_0)、注药后5 min(T_1)、注药后10 min(T_2)、注药后30 min(T_3)、注药后60 min(T_4)时的心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO_2)。结果患者麻醉起效时间为(36.75±5.42)s,运动阻滞起效时间为(6.63±2.11)min,麻醉平面固定时间为(12.37±2.59)min,最大Bromage评分为(2.03±0.45)分。麻醉后T_1、T_2、T_3、T_4各个时间点的HR、MAP、SpO_2与麻醉前(T_0)比较差异均无统计学意义(P>0.05)。结论轻比重布比卡因腰硬联合麻醉能减少老年髋关节置换术中血流动力学波动,是一种安全、可靠的麻醉方式。
Objective To evaluate the efficacy of combined spinal and epidural anesthesia with hypobaric bupivacain in elderly patients with hip joint replacement. Methods Clinical data of 47 elderly patients who undement hip joint replacement by combined spinal and epidural anesthesia with hypobaric bupivacain were retrospectively analyzed.Onset time of anesthesia, onset time of motor block, plane fixed time of anesthesia, maximum bromage score as well as complications like low blood pressure,bradyaiThythmia,respiratoiy depression,nausea and vomiting, urinaiy retention, etc were recorded.Conventional he-modynamic monitoring was performed in heart rate（ HR） ,mean arterial blood pressure（ MAP） and saturation of pulse oxygen （Sp02） before injection（ T0） ,5 min alter injection（T, ） ,10 min alter injection（ T2） ,30 min alter injection（ T3） and 60 min alter injection（ T4 ） .Results The onset time of anesthesia was （ 36.7 5 ± 5 .42） s , the onset time of motor block was （ 6.63± 2. 11） min,the plane fixed time of anesthesia was （ 12.37±2.59） min,and the maximum Bi’omage score was （2.03±0.45） scores.There was no statistically significant difference in HR,MAP,Sp02 between eveiy time point（T, ,T2, T3, T4） alter an-aesthesia and before anaesthesia （ T0） （ P 〉 0.05） . Conclusion Combined spinal and epidural anesthesia with hypobaricbupivacaine can reduce intraoperative hemodynamic fluctuations in hip joint replacement for the elderly patients,and it is sale and reliable.
出处
《右江医学》
2016年第4期416-418,共3页
Chinese Youjiang Medical Journal
关键词
布比卡因
轻比重
腰硬联合麻醉
髋关节置换术
老年患者
bupivacaine
hypobaric
combined spinal and epkluml anesthesia
hip joint replacement
elflerly patient
