摘要
目的:探讨罗哌卡因复合舒芬太尼在老年患者腰硬联合麻醉中的临床效果。方法:将择期行股骨手术(股骨颈骨折、股骨干骨折及股骨远端骨折)的老年患者60例,按随机数字表法分为A,B,C 3组,分别给以0.5%罗哌卡因7.5 mg,0.5%罗哌卡因7.5 mg复合舒芬太尼5μg,0.5%罗哌卡因6 mg复合舒芬太尼5μg。比较3组麻醉效果、循环变化、运动阻滞程度及麻醉不良反应情况。结果:所有患者均成功实施腰硬联合麻醉,并顺利完成手术。与A,B 2组比较,C组的MAP,HR变化更平稳(P<0.05),其到达最高感觉阻滞平面的时间也优于前者,同时C组中痛觉退至T12时间和痛觉阻滞持续时间也明显优于其他2组,其中B组优于A组(P<0.01)。3组的VAS评分时间点差异有统计学意义(P<0.05),但组间、组间·时间点交互作用差异无统计学意义(P>0.05)。3组中C组无明显不良反应。结论:0.5%罗哌卡因6 mg复合舒芬太尼5μg腰硬联合麻醉在老年患者股骨骨折手术中,麻醉平稳,痛觉阻滞满意,无不良反应,同时可实施硬膜外术后镇痛,值得临床应用。
Objective：To analyze the effect of small dose ropivacaine combined with sufentanil in combined spinal-epidural anesthe- sia for operation of elderly patients femoral fracture. Methods：60 selected surgical elderly patients （ femoral fracture} were randomly di- vided into three groups. Group A was treated with 0. 5% ropivacaine 7.5mg, Group B with 0.5% ropivaeaine 7.5mg ＋ sufentanil 5. Oug and Group C with 0.5% ropivacaine 6.0mg ＋ sufentanil 5.0μg. Effects of anesthesia,changes of circulation,block extent of movement and adverse reactions were evaluated and compared among the three groups. Results：All the patients obtained successful op- eration results with combined spinal-epidural anesthesia. Group C obtained the most stable MAP and HR （ P 〈0. 05 ） compared with Groups A and B. Group C was better than groups A and B in average time to reach the highest sensory block levels. And Group C was absolutely superior to other groups in time retreating to T12 and in duration of sensory block （ P 〈 0.01 ）. VAS among the three groups was of statistic significance （P 〈0.05 ） but the interaction of inter-group and inter-group time point showed no significant difference （P 〉 0. 05 ）. There was no significant adverse effect in group C. Conclusion ：0.5% ropivacaine 6mg combined with sufentanil 5ug used for combined spinal-epidural anesthesia in elderly patients of femoral fracture operation produced stable anaesthetic effect. The result of al- gesia block meets the satisfaction of patients. There are no obvious adverse reactions. It is worthy of clinical application.
出处
《淮海医药》
CAS
2018年第2期147-149,共3页
Journal of Huaihai Medicine
