摘要
目的比较硬膜外不同给药方式在老年患者手术中的临床效果分析。方法 96例择期行手术的老年患者,按照不同的给药方式将患者均为两组（n=48）。持续给药组患者实施连续硬膜外穿刺成功后注入2%利多卡因试验量3 mL,调节麻醉平面达T10且固定后根据患者情况硬膜外连续输注2%利多卡因3-5 mL/h,至手术结束。分次给药组患者同样行硬膜外麻醉,调节麻醉平面达T10且固定后硬膜外分次注入2%利多卡因3-5 mL/h,每半小时注射1次。观察两组麻醉阻滞情况及不同时间点血流动力学变化。结果两组患者感觉阻滞起效时间基本相同,均能阻滞到最高平面T10,但持续给药组阻滞完善时间和用药总量均少于分次给药组,差异有显著性意义（P〈0.05）。给药后两组血压均有明显下降,分次给药组术中追加药物后血压较持续给药组下降明显（P〈0.05）,波动较大,不如持续给药组稳定。结论硬膜外麻醉持续给药比传统的间断分次给药对老年患者血流动力学的影响小,有利于维持循环稳定,提高围术期安全性。
Objective To compare the clinical effect of intravenous or epidural surgery in elderly patients. Methods96 cases of elective surgery in elderly patients were two groups of patients after the implementation of continuous administration continuous epidural successfully injected test dose of 2% lidocaine 3 mL,adjusting anesthesia of T10 and fixed according to the patient＇s condition after dural continuous infusion of 2% lidocaine outside 3- 5ml / h,until the end of surgery. Sub- group of patients with the same dose epidural anesthesia,adjusting anesthesia of T10 and graded after a fixed epidural injection of 2% lidocaine 3 - 5 mL / h,1 injection every half hour. Cases were observed of anesthesia and hemodynamic changes at different time points. Results There were sensory block onset time is basically the same,can block to the highest plane T10,but continuous administration group complete block of time and amount of medication were less than fractionated dose group（ P〈0. 05）. After administration of the two groups were significantly reduced blood pressure,after sub- group of patients additional doses of drug in blood pressure than the continuous treatment group decreased significantly（ P〈0. 05）,volatile,as sustained and stable administration group. Conclusions The continuous administration of epidural anesthesia on hemodynamics in small elderly patients than traditional intermittent divided doses to help maintain stable circulation,improve perioperative safety.
出处
《航空航天医学杂志》
2016年第9期1089-1091,共3页
Journal of Aerospace medicine
关键词
硬膜外麻醉
高龄
持续给药
分次给药
epidural anesthesia
elderly
continuous administration
divided doses
