坐位穿刺腰硬联合麻醉在老年患者前列腺手术中应用.docVIP

坐位穿刺腰硬联合麻醉在老年患者前列腺手术中应用 　　[摘要] 目的 比较不同体位穿刺腰硬联合麻醉对老年前列腺手术患者血流动力学、麻醉平面、麻醉操作的影响。 方法 选择2014年10月～2015年10月西宁市第一人民医院择期行前列腺电切术年龄≥65岁的患者60例，按照随机数字表法分为L组和S组，每组各30例。L组患者侧卧位行腰硬联合麻醉，S组患者坐位下行腰硬联合麻醉，记录患者入室后，蛛网膜下腔给药后5、10、15、20、25、30 min的平均动脉压、心率；蛛网膜下腔给药后每5分钟测量1次麻醉平面至给药后20 min；观察两组患者的麻醉效果，麻醉操作中腰椎穿刺的次数；手术结束时由患者对麻醉的满意度进行评价。 结果 L组腰麻给药后各个时点的平均动脉压低于入室后（P 0.05）。L组给药后15 min心率较入室后下降（P 0.05），麻醉操作中S组腰椎穿刺次数少于L组（P 0.05），患者对麻醉满意度的评价S组优于L组（P 0.05）。 结论 两种体位腰硬联合麻醉在老年患者前列腺手术中的应用能达到相同的麻醉效果，坐位下血流动力学平稳更易完成腰硬联合麻醉的穿刺。 　　[关键词] 腰硬联合麻醉；老年；坐位；前列腺手术 　　[中图分类号] R614 [文献标识码] A [文章编号] 1673-7210（2016）05（a）-0057-04 　　[Abstract] Objective To compare the influence of hemodynamic changes， the block levels of anesthesia and anesthesia procedure in spinal-epidural anesthesia with different position puncture on elderly patients with prostate surgery. Methods From October 2014 to October 2015， in Xining First Peoples Hospital， 60 elderly patients age ≥65 years with elective transurethral plasmakinetics resection of the prostate surgery were selected， according to random number table， they were divided into group L and group S， with 30 cases in each group. Patients in L group were given lumbar puncture in lateral position， patients in group S were given lumbar puncture in sitting position. Mean arterial pressure and heart rate coming in operating room， after subarachnoid injection 5， 10， 15， 20， 25， 30 min were recorded； the block levels were evaluated for 20 minutes， in 5 min intervals， the effect of anesthesia， number of needle insertion for lumbar puncture were observed； the satisfaction of patients for anesthesia were evelated after surgery. Results In group L， mean arterial pressure of each time point after subarachnoid injection were significantly lower than that coming in operating room （P 0.05）. In group L， heart rate after subarachnoid injection 15 min were lower than coming that in operating room （P 0.05）. The numbers of needle insertion for lumber puncture in group S was significantly less than thaose