小剂量布比卡因混合舒芬太尼腰椎麻醉在老年病人经尿道前列腺电切术中的应用_医学论文.docVIP

小剂量布比卡因混合舒芬太尼腰椎麻醉在老年病人经尿道前列腺电切术中的应用_医学论文 小剂量布比卡因混合舒芬太尼腰椎麻醉在老年病人经尿道前列腺电切术中的应用_医学论文 作者：孙晓燕 王寿世 吴卫平 范晓琳 于文刚 【摘要】 目的 探讨小剂量布比卡因、舒芬太尼用于老年经尿道前列腺电切术(TURP)病人腰椎麻醉的效果。方法 将50例TURP病人随机分为A、B、C 3组，A组以3 g/L布比卡因1 mL+0.01 g/L舒芬太尼1 mL+100 g/L葡萄糖溶液1 mL进行腰椎麻醉B组以5 g/L布比卡因1 mL+0.01 g/L舒芬太尼1 mL+100 g/L葡萄糖溶液1 mL进行腰椎麻醉C组以3.75 g/L布比卡因2 mL+100 g/L葡萄糖溶液1 mL进行腰椎麻醉。记录注药前即刻(T0)及注药后5 min(T1)、15 min(T2)、30 min (T3)时平均动脉压(MAP)、心率(HR)记录感觉阻滞范围(以节段数表示)、镇痛持续时间、运动神经阻滞完全恢复时间、麻黄素使用例数。结果 B、C组T1、T2、T3 MAP值与T0比较均明显降低(t=8.246～21.574,0.01)。与B、C两组相比，A组30 min后麻醉阻滞范围明显减小(F=5.24,q=3.006、4.509,0.05)。A、B组镇痛时间明显长于C组(F=27.49,q=7.598、10.031,0.01)。A、B两组麻黄素使用例数明显少于C组(P=0.004 5、0.000 1)，A组运动神经恢复时间明显少于B、C两组(F=70.60, q=12.999、15.824,0.01)。结论 3 mg布比卡因混合舒芬太尼10 μg用于椎管内麻醉对TURP老年人血流动力学功能影响小，运动恢复快。 【关键词】 布比卡因舒芬太尼麻醉,脊椎经尿道前列腺切除术老年人 [ABSTRACT] Objective To explore the effectiveness of combined low 1 mL of 3 g/L bupivacaine and 1 mL of 0.01 g/L sufentany mixed in 1 mL of 100 g/L glucose solution group B (n=17), 1 mL of 5 g/L bupivacaine and 1 mL of 0.01 g/L sufentany in 1 mL of 100 g/L glucose solution group C (n=17), 2 mL of 3.75 g/L bupivacaine in 1 mL of 100 g/L glucose solution. Mean arterial pressure (MAP) and heart rate (HR) were recorded before drug infusion (T0), 5 minutes (T1), 15 minutes (T2) and 30 minutes (T3) after drug infusion. The range of senseblocking (recorded as section number), analgesic duration, and recovery time of motor nerve function were examined. The number of patients using ephedrine during anesthesia was recorded. Results The MAPs of T1, T2 and T3 in groups B and C were significantly decreased compared with that of T0 (t=8.246-21.574,0.01). The senseblocking range of group A 30 min after drug infusion was significantly smaller than that of groups B and C (F=5.24q=3.006,4.5090.05)The analgesic duration in groups A and B was significantly longer than that in group C (F=27.49q=7.598,10.0310.01).The number of patients using ephedrine in groups A and group B was smaller than that in group C (P=0.004 5,0.00