Heavy weight and light weight of L-bupivacaine for unilateral spinal - epidural block in the ultra-application of lower extremity surgery in elderly.docVIP

 PAGE \* MERGEFORMAT 3 Heavy weight and light weight of L-bupivacaine for unilateral spinal - epidural block in the ultra-application of lower extremity surgery in elderly [Keywords:] emphasis on light-weight ratio of L-bupivacaine for unilateral spinal - epidural block ultra-lower extremity surgery in elderly Within the venous catheter, in the anesthesia before the importation of lactate Ringer’s solution 300 ~ 500ml, the first lumbar 2,3 or 3,4-clearance first lumbar epidural puncture, and then apply the needle-needle combined spinal-epidural anesthesia needles 0.1ml / s injection rate of liquid anesthesia out after spinal anesthesia needle, epidural catheter to the head, back needle inserted into epidural catheter, injection side after 20min, in the lateral position adjustment of anesthesia in the chest 10 below. Re-weight ratio: 0.75% L-bupivacaine 1ml 10% glucose injection volume of 1:1 mixture; lighter than the reorganization: 0.75% L-bupivacaine 1ml sterile water for injection volume of 1:1 mixture; control group: 0.75% levobupivacaine 1ml 0.9% sodium chloride injection volume of 1:1 mixture. Control group, injection of anesthesia, after supine adjustment. Routine intraoperative oxygen, line blood pressure (BP), electrocardiogram (ECG), blood oxygen saturation (SpO2) routine monitoring, if BP less than the basic value of 30% or less than 90mmHg, while intravenous ephedrine 5mg. If the heart rate (HR) is slower than 50 beats / min, then intravenous atropine 0.25mg. 1.3 monitoring indicators ① pain block plane test: Determination of acupuncture in patients with cutaneous sensory segment for the block plane disappeared; ② motor block assessment: Method for Evaluation of a modified Bromage motor block scores in the standard [1]; ③ narcotic effect: Priority: intraoperative pain, the patient quiet and cooperative, patients were satisfied; good: painless cooperation, poor intraoperative muscle relaxation, but does not affect the operation; difference: occ