| 涂琴琴.小剂量轻比重不同浓度罗哌卡因单侧腰—硬联合麻醉在老年患者全髋关节置换术中的应用[J].安徽医药,2016,20(1):163-166. |
| 小剂量轻比重不同浓度罗哌卡因单侧腰—硬联合麻醉在老年患者全髋关节置换术中的应用 |
| Lateral combined spinal-epidural anesthesia with hypobaric ropivacaine of small dose and different concentrations applied in elderly patients treated with total hip arthroplasty |
| 投稿时间：2015-06-29 |
| DOI： |
| 中文关键词: 腰—硬联合麻醉 小剂量 轻比重 罗哌卡因 全髋关节置换术 |
| 英文关键词: combined spinal-epidural anesthesia small dose hypobaric ropivacaine total hip arthroplasty |
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| 中文摘要: |
| 目的 观察不同浓度的小剂量轻比重罗哌卡因应用于单侧腰—硬联合麻醉在老年患者全髋关节置换术效果及安全性。方法 选择该院于2014年1月—2015年4月收治的需行全髋关节置换术老年患者60例作为研究对象,均符合手术指证,ASA分级Ⅰ~Ⅱ级,按照配对分组法分为三组,每组20例,三组患者均选择L3-4作为穿刺节段,A组给与0.15%罗哌卡因2.5 mL,B组给与0.25%罗哌卡因2.5 mL,C组给与0.5%罗哌卡因2.5 mL,比较三组患者效果,并统计不良反应发生率。结果 A组、B组两组比较,麻醉前、麻醉后及术毕平均动脉压(MAP)及心率(HR)均无显著统计学差异,均P>0.05；C组麻醉后及术毕平均动脉压MAP均显著低于A组、B组,HR显著高于A组、B组,均P>0.05。B组平面消退时间、运动阻滞恢复时间均高于A组,低于C组,均P<0.05；B组运动阻滞起效时间低于A组,高于C组,均P<0.05。B组不良反应5例(25.0%)与A组2例(10.0%)比较,差异无统计学意义,P>0.05；A组、B组不良反应发生率显著低于C组,均P<0.05。三组患者呼吸频率(RR)及潮气量(Vt)比较均无显著统计学差异,P>0.05。结论 0.25%罗哌卡因2.5ml轻比重罗哌卡因应用于单侧腰—硬联合麻醉在老年患者全髋关节置换术效果较佳,且不良反应发生率低,具有重要临床价值。 |
| 英文摘要: |
| Objective To observe effect and safety of lateral combined spinal-epidural anesthesia with hypobaric ropivacaine of small dose and different concentrations applied in elderly patients treated with total hip arthroplasty.Methods We selected 60 cases of elderly patients treated with total hip arthroplasty in Huangshi Center Hospital from January 2014 to April 2015 as research objects. All patients were in line with the indications for surgery with ASA gradeⅠ~Ⅱ. Then according to paired grouping method they were assigned into three groups with 20 cases in each group. L3-4 was selected as puncture segment in all patients of the three groups. Group Awas given 0.15% ropivacaine 2.5 mL, group B 0.25% ropivacaine 2.5 mL, group C 0.5% ropivacaine 2.5 mL. Effect and adverse reaction incidence were compared among patients.ResultsBetween group Aand group Bbefore anesthesia, after anesthesia and postoperation mean arterial pressure (MAP) and heart rate (HR) had no significant difference (P>0.05). After anesthesia and postoperation mean arterial pressure (MAP) in group Cwas significantly lower than in group A, group Band HR was significantly higher than in group Aand group B (P>0.05). The regression time and recovery time of motion blockade in group Bwas higher than that in group Awhile lower than that in group C (P<0.05). The onset time of motion blockade in group Bwas lower than that in group Awhile higher than that in group C (P<0.05). There were no significant differences in adverse reactions between group B (5 cases, 25%) and group A (2 cases, 10.0%) (P>0.05). Incidences of adverse reactions in group Aand group Bwere significantly lower than that in Cgroup (P<0.05). There were no statistically significant difference in respiratory rate (RR) and tidal volume(Vt) among three groups (P>0.05). Conclusions The application of 2.5 ml of 0.25% ropivacaine to combined spinal-epidural anesthesia in elderly patients treated with total hip arthroplasty has better effect, and the adverse reaction rate is lower, which has an important clinical value. |
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