小剂量布比卡因腰硬联合麻醉在老年患者髋关节手术中的应用

戚晓雷; 刘刚

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小剂量布比卡因腰硬联合麻醉在老年患者髋关节手术中的应用

戚晓雷 , 刘刚

文章导航 > 蚌埠医学院学报 > 2013, 37 > 8: (951-952,955)

引用本文:

Citation:

小剂量布比卡因腰硬联合麻醉在老年患者髋关节手术中的应用

戚晓雷¹,
刘刚²

1.
1. 安徽省砀山县人民医院麻醉科, 235300;
2.
3.
2. 蚌埠医学院第一附属医院麻醉科, 安徽蚌埠 233004

作者简介: 戚晓雷(1974－)，男，主治医师.

基金项目:

Using low-dose of bupivacaine in combined spinal and epidural anaesthesia in hip surgery for the elderly

QI Xiao-lei¹,
LIU Gang²

1.
1. Department of Anesthesiology, Dangshan County People’s Hospital, Dangshan Anhui 235300;
2.
2. Department of Anesthesiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233004, China

摘要: 目的:评价小剂量布比卡因腰硬联合麻醉用于老年患者髋关节手术中的安全性和有效性。方法:将60例ASAⅡ～Ⅲ级行髋关节手术的老年患者随均机分为观察组(0. 75%布比卡因1 ml)和常规组(0. 75%布比卡因2 ml),各30例,2组均采用腰硬联合麻醉。根据血压和出血情况来调整输液和输血。观察2组感觉阻滞起效时间、阻滞完善时间、阻滞最高平面、硬膜外腔注药次数,以及麻醉前和蛛网膜下腔注药后5、15、30 min时的收缩压、舒张压、心率。结果:2组的麻醉起效时间、阻滞完善时间、硬膜外腔注药次数差异均无统计学意义(0. 05);观察组在蛛网膜下腔注药后5、15、30 min对收缩压、舒张压的影响均小于常规组(P0. 05～P0. 01),观察组在5 min对心率的影响小于常规组(P0. 01)。结论:小剂量布比卡因腰硬联合麻醉在老年患者髋关节手术中血流动力学状态稳定,麻醉效果良好。
- 髋关节手术 /
- 布比卡因 /
- 腰硬联合麻醉
Abstract: Objective: To evaluate the safety and efficacy of using low-dose of bupivacaine in combined spinal and epiduralanaesthesia( CSEA) in hip surgeries for the elderly. Methods: Sixty elderly patients( ASA physical status Ⅱ to Ⅲ) scheduled for the hip surgery were randomly divided into observation group ( 30 cases，receiving 1 ml of 0. 75% bupivacaine) and control group( 30 cases， receiving 2 ml of 0. 75% bupivacaine) ; CSEA was performed in both groups. The intravenous transfusion and infusion were determined according to the blood pressure and bleeding volume of the patients. The onset time of the sensory block， time to complete block， the highest sensory block level and the number of epidural bupivacaine injections were recorded. The systolic blood pressure， diastolic blood pressure and heart rate before the anesthesia and 5， 15 and 30 minutes after CSEA were observed. Results: There were no significant differences in the onset time of the sensory block， time to complete block and number of epidural bupivacaine injections between the two groups( P ＞ 0. 05) . The changes of the blood pressure of the observation group at 5， 15 and 30 minutes after CSEA were not obvious as compared to those of the control group( P ＜ 0. 05 to P ＜ 0. 01) . The heart rate of the observation group was less affected by anaesthesia at 5 minutes after CSEA than that of the control group( P ＜ 0. 01) . Conclusions: Low-dose of bupivacaine in CSEA may achieve an ideal anesthetic effect and keep a stable hemodynamic status in the elderly patients receving hip surgeries.
- hip surgery /
- bupivacaine /
- combined spinal and epidural anaesthesia

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小剂量布比卡因腰硬联合麻醉在老年患者髋关节手术中的应用

戚晓雷¹
刘刚²

作者简介: 戚晓雷(1974－)，男，主治医师.

1. 1. 安徽省砀山县人民医院麻醉科, 235300;
2.
3. 2. 蚌埠医学院第一附属医院麻醉科, 安徽蚌埠 233004

收稿日期: 2013-01-05
网络出版日期: 2013-08-15

基金项目:

关键词:

摘要: 目的:评价小剂量布比卡因腰硬联合麻醉用于老年患者髋关节手术中的安全性和有效性。方法:将60例ASAⅡ～Ⅲ级行髋关节手术的老年患者随均机分为观察组(0. 75%布比卡因1 ml)和常规组(0. 75%布比卡因2 ml),各30例,2组均采用腰硬联合麻醉。根据血压和出血情况来调整输液和输血。观察2组感觉阻滞起效时间、阻滞完善时间、阻滞最高平面、硬膜外腔注药次数,以及麻醉前和蛛网膜下腔注药后5、15、30 min时的收缩压、舒张压、心率。结果:2组的麻醉起效时间、阻滞完善时间、硬膜外腔注药次数差异均无统计学意义(0. 05);观察组在蛛网膜下腔注药后5、15、30 min对收缩压、舒张压的影响均小于常规组(P0. 05～P0. 01),观察组在5 min对心率的影响小于常规组(P0. 01)。结论:小剂量布比卡因腰硬联合麻醉在老年患者髋关节手术中血流动力学状态稳定,麻醉效果良好。

English Abstract

Using low-dose of bupivacaine in combined spinal and epidural anaesthesia in hip surgery for the elderly

QI Xiao-lei¹
LIU Gang²

1. 1. Department of Anesthesiology, Dangshan County People’s Hospital, Dangshan Anhui 235300;
2. 2. Department of Anesthesiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233004, China

Received Date: 2013-01-05
Available Online: 2013-08-15

Abstract: Objective: To evaluate the safety and efficacy of using low-dose of bupivacaine in combined spinal and epiduralanaesthesia( CSEA) in hip surgeries for the elderly. Methods: Sixty elderly patients( ASA physical status Ⅱ to Ⅲ) scheduled for the hip surgery were randomly divided into observation group ( 30 cases，receiving 1 ml of 0. 75% bupivacaine) and control group( 30 cases， receiving 2 ml of 0. 75% bupivacaine) ; CSEA was performed in both groups. The intravenous transfusion and infusion were determined according to the blood pressure and bleeding volume of the patients. The onset time of the sensory block， time to complete block， the highest sensory block level and the number of epidural bupivacaine injections were recorded. The systolic blood pressure， diastolic blood pressure and heart rate before the anesthesia and 5， 15 and 30 minutes after CSEA were observed. Results: There were no significant differences in the onset time of the sensory block， time to complete block and number of epidural bupivacaine injections between the two groups( P ＞ 0. 05) . The changes of the blood pressure of the observation group at 5， 15 and 30 minutes after CSEA were not obvious as compared to those of the control group( P ＜ 0. 05 to P ＜ 0. 01) . The heart rate of the observation group was less affected by anaesthesia at 5 minutes after CSEA than that of the control group( P ＜ 0. 01) . Conclusions: Low-dose of bupivacaine in CSEA may achieve an ideal anesthetic effect and keep a stable hemodynamic status in the elderly patients receving hip surgeries.