摘要
目的分析0.25%罗哌卡因对膝、髋关节置换术患者腰麻阻滞效果和应激反应的影响。方法抽取2019年2月至2021年3月于驻马店市中心医院行膝、髋关节置换术患者80例,按随机数字表法分为低浓度组(40例)与高浓度组(40例)。两组均行腰麻,高浓度组采用0.5%罗哌卡因,低浓度组采用0.25%罗哌卡因,对比两组麻醉前(T1)、麻醉后5 min(T2)、麻醉后15 min(T3)、麻醉后30 min(T4)应激反应、阻滞效果(感觉阻滞时间、运动阻滞时间、麻醉平面稳定时间)、恢复情况(麻醉平面消失时间、运动阻滞恢复时间)、Remesay镇静评分、不良反应发生率。结果T2、T3、T4时,低浓度组心率(HR)、平均动脉压(MAP)、收缩压(SBP)较高浓度组高(P<0.05);低浓度组和高浓度组感觉阻滞时间、运动阻滞时间、麻醉平面稳定时间比较,P>0.05;低浓度组麻醉平面消失时间、运动阻滞恢复时间较高浓度组短(P<0.05);麻醉后30、60 min,低浓度组Remesay镇静评分较高浓度组高(P<0.05);低浓度组不良反应发生率(7.50%)较高浓度组(25.00%)低,P<0.05。结论0.25%罗哌卡因应用于膝、髋关节置换术腰麻中,不会影响阻滞效果,还可减轻应激反应,改善镇静效果,缩短恢复时间,并可降低不良反应发生率,提高麻醉安全性。
Objective To analyze the effect of 0.25% ropivacaine on spinal anesthesia block and stress response in patients undergoing knee or hip replacement.Methods A total of 80 patients underwent knee or hip replacement in Zhumadian Central Hospital from February 2019 to March 2021 were selected,and divided into low concentration group(n=40)and high concentration group(n=40)according to random number table method.Both groups received spinal anesthesia,0.5% ropivacaine was used in the high concentration group,and 0.25% ropivacaine was used in the low concentration group.Stress responses,block effect(sensory block time,movement block time,anesthesia level stability time),recovery(anesthesia level disappearance time,movement block recovery time),Ramsay sedation score,incidence of adverse reactions before anesthesia(T1),5 min after anesthesia(T2),15 min after anesthesia(T3),and 30 min after anesthesia(T4)were compared between the two groups.Results At T2,T3 and T4,the heart rate(HR),mean arterial pressure(MAP)and systolic blood pressure(SBP)in the low concentration group were higher than those in the high concentration group(P<0.05).The sensory block time,movement block time and anesthesia level stability time were compared between the low concentration group and high concentration group(P>0.05).The anesthesia level disappearance time,movement block recovery time in the low concentration group were shorter than those in the high concentration group(P<0.05).Thirty and sixty minutes after anesthesia,the Ramsay sedation scores in the low concentration group were higher than those in the high concentration group(P<0.05).The incidence of adverse reactions in the low concentration group(7.50%)was lower than that in the high concentration group(25.00%),P<0.05.Conclusions The application of 0.25% ropivacaine in spinal anesthesia for knee or hip replacement does not affect the blocking effect,it can reduce stress reaction,improve sedation effect,shorten recovery time,reduce the incidence of adverse reactions and improve the safety of anesthesia.
作者
樊彩霞
王震
赵晨璐
Fan Caixia;Wang Zhen;Zhao Chenlu(Department of Anesthesiology,Zhumadian Central Hospital,Zhumadian 463000,China)
出处
《中国实用医刊》
2021年第24期58-61,共4页
Chinese Journal of Practical Medicine
关键词
麻醉
膝关节置换术
髋关节置换术
罗哌卡因
腰麻
阻滞效果
应激反应
Anesthesia
Knee replacement
hip replacement
Ropivacaine
Spinal anesthesia
Block effect
Stress response
