三种不同局麻药蛛网膜下腔阻滞用于老年病人剂量-效应关系-dose-effect relationship of three different local anesthetics for subarachnoid block in elderly patients.docxVIP

广州医学院硕士学位论文三种不同局麻药蛛网膜下腔阻滞用于老年病人的剂量 广州医学院硕士学位论文 三种不同局麻药蛛网膜下腔阻滞用于老年病人的剂量-效应关系 PAGE 6 PAGE 6 The Dose-response Relationship of Three Local Anesthetics After Intrathecal Injection for Elderly Patients MSc. Candidate：Zheng Bin Supervisor: Prof. She Shouzhang Department of Anesthesiology, Guangzhou First Municipal People’s Hospital， Guangzhou Medical College ABSTRACT Background With the improvement of living standards and health care system, the average life expectancy in China has been much longer than before, the ratio of the elderly people has increased obviously, and the amount of elderly patients undergoing surgery has become larger and larger in most of the hospitals. This phenomenon has excited the attention of many anesthesiologists. How to ensure the safety and efficacy of anesthesia is especially important. Levobupivacaine and ropivacaine, two new long-acting local anesthetics, have been developed as an alternative to bupivacaine, after the evidence of its severe toxicity. Both of these agents are pure left-isomers and, due to their three-dimensional structure, seem to have less toxic effects on the central nervous system and on the cardiovascular system. A large number of studies confirmed that intrathecal or epidural injection of levobupivacaine or ropivacaine are safe and effective. We can expect that levobupicacaine and ropivacaine using in spinal anesthesia or analgesia will have broad application prospects. As we all know, being bedridden is one of the important factors of deep vein thrombosis , early motor resumption can shorten the time of patients stay in bed and to avoid the complication of deep vein thrombosis. Spinal block will always lead to sensory and motor block. The aim of this study was how to select the appropriate local anesthetic, and the appropriate dose of local anesthetic in order to not only make an excellent effects of sensory block, but also to avoid unexpected deep motor block. Therefore this study compared the sensory and motor blo