摘要
目的 :观察罗哌卡因腰麻对老年高血压病人下肢手术的血压、心率的影响 ,以探讨其临床应用的可行性。方法 :4 8例老年高血压患者 ,择期下肢手术。行罗哌卡因腰麻 ,观察血压、心率变化 ,记录麻醉特点及腰麻并发症。结果 :所有病人麻醉效果均好。麻醉后各时间点血压均低于麻醉前 (P <0 .0 1) ,各时间点收缩压下降幅度在 8.12 %～ 14 .84 %之间。麻醉后 5min和 10min时心率比麻醉前增快 (P <0 .0 1)。麻醉时间为 (2 80± 82 )min。最高麻醉平面为T11～T3 ,中位数为T10 。副作用为术后头痛 2例 ,腰背痛 8例 ,恶心呕吐 1例 ,尿潴留 8例。结论 :对老年高血压病人在有效降压的前提下行罗哌卡因腰麻 ,其循环和呼吸系统较稳定 ,麻醉效果好 。
Objective:To evaluate the effect of intrathecal ropivacaine on blood pressure(BP)?heart rate (HR) and side effects in the aged patients with hypertension.Methods:forty eight patients aged from 65 to 93 with hypertension received 3 ml of intrathecal 0.5% ropivacaine at L 3～4 level. BP?HR?SpO 2 and side effects were observed after spinal anesthesia.Results:Anesthesia was very effective in all patients. BP was decreased significantly compared with pre anesthesia values(P<0.01). Range of systolic pressure(SBP) value fell from 8.12% to 14.84% after anesthesia. Mean of the lowest BP was (112±22) mmHg.A large decreased of SBP (larger than 30% of the base values ) were observed in 7 patients. HR at 5 min and 10min after the drug induction increased markedly than that before anesthesia(P<0.01).Compared with that of 5 min?10 min after the anesthesia, HR decreased significantly after 20 min (P<0.01).HR remained nolonger than 60 beat per minute at all patients after the onset of anesthesia. The time of anesthesia course was (280±82)min.The level of anesthesia was T 11 ～T 3.Median was T 10 .Levels of block at seven patients of hypotension after anesthesia exceed T 6 level. The side effects include headache (2 patients),lumbar pain(8 patients),nausea and vomiting(1 patient) ,retention of urine (8 patients).Conclusion:Circulation system and respiratory system in the aged patient with hypertension are stable after the use of intrathecal ropivacaine.
出处
《温州医学院学报》
CAS
2002年第4期224-226,共3页
Journal of Wenzhou Medical College
