轻比重布比卡因单侧腰麻在高龄患者下肢手术临床研究.docVIP

轻比重布比卡因单侧腰麻在高龄患者下肢手术临床研究 　　【摘要】 目的 探讨单侧腰麻用于高龄患者下肢手术的可行性，比较不同剂量轻比重布比卡因在高龄患者下肢手术中的临床效果。方法 90例行下肢手术的高龄患者随机分为 A、B、C 3组，3组腰麻液用量分别为：0.25%轻比重布比卡因5、7、9 mg，比较三组临床麻醉效果及不良反应的差异性。结果 3种不同的布比卡因剂量均可产生一个单侧感觉、运动神经阻滞的麻醉效果。A组与B组比较：麻醉起效时间、麻醉平面固定时间、有效镇痛时间、发生低血压例数，差异无统计学意义(P0.05)； C组与A、B组比较：麻醉起效时间、麻醉平面固定时间，差异无统计学意义(P0.05)，但在麻醉有效镇痛时间上C组明显优于A、B组，差异有统计学意义(P 　　【关键词】 腰硬联合麻醉； 腰麻；高龄老年人； 轻比重布比卡因 　　?? 　　 　　Hypobaric bupivacaine unilateral spinal anesthesia in elderly patients with unilateral lower limb surgery in clinical research 　　 　　WANG Hua.Department of Anesthesiology 　　Dongguan Dalingshan Hospital Dongguan, Guangdong 523820,China 　　? 　　【Abstract】 Objective 　　To investigate the unilateral spinal anesthesia for lower limb surgery in elderly patients the possibility to compare different doses of hypobaric bupivacaine for lower limb surgery in elderly patients in clinical effects. Methods 90 elderly routine lower extremity surgery were randomly divided into A,B,C three groups, three groups of spinal fluid volume were: 0.25% hypobaric bupivacaine 5, 7, 9 mg, compared three groups of clinical anesthesia and differences in adverse reactions. Results Three different doses of bupivacaine may produce a unilateral sensory and motor nerve block anesthesia. A group and B group: The onset time of anesthesia, anesthesia fixed time, effective analgesia, hypotension number of cases, the difference was not statistically significant (P0.05).C group and A, B group: from anesthesia onset time, anesthesia time fixed, the difference was not statistically significant (P0.05), but an effective analgesic in anesthesia time was significantly better than group C on A, B group, the difference was statistically significant (P[1,2]，在此基础上我们进行了单侧腰麻的研究，对三种剂量的轻比重布比卡因用于高龄患者下肢手术进行对比观察。? 　　1 资料与方法? 　　 　　1.2 麻醉方法 患者入室后，常规开放静脉、吸氧、监测HR、BP、ECG、SPO??2?，麻醉前预输胶体150~300 ml，取患肢在上卧背曲位，用BD腰硬联合包于L??2-3?或L??3-4?腰硬联合穿刺。穿刺成功后，将腰麻穿刺针斜面朝向后上，向蛛网膜下隙注入0.25%轻比重布比卡因(用0.75%布比卡因+生理盐水按1:2比例配置)，A组5 mg、B组7 mg、C组9 mg，注药时间20~30 s，注药完毕推出腰穿针，于硬