硬膜外试验剂量在老年人麻醉中的可靠性探讨

THE RELIABILITY OF EPIDURAL TEST DOSE IN THE ELDERLY

将70例硬膜外麻醉病人分为60岁以下组和60岁以上组(老年组)。按自身交叉随机设计原则在硬膜外或静脉内注射2%利多卡因3ml(含肾上腺素15μg)。静注后老年组和非老年组心率分别增快18.8±8.60beat/min 和29.3±16.64beat/min(P<0.01);分别有11例和32例病人有自觉症状(P<0.01)。单独据心率或症状判断试验液是否误注血管,准确性分别为老年组88.5%或84.25,非老年组94.2%或95.7%;联合判断其准确率分别为90.0%和95.7%。提示硬膜外试验剂量在老年人麻醉中的可靠性较差。

The reliability of epinephrine-containing epidural test dose in the elderly(≤60 years old) and in the non-elderly were studied in 70 patients undergong epidural anesthesia.The dupilicated (introvenous and epidural)injection of 3 ml of lidocaine (5μg/ml epinephrine)were performed in a random,self-cross-over design.The results were as follow:The peak-to-peak HR in elderly pa- tients and younger patients were 18.8±8.60 beat/min and 29.3±16.64beat/min,respectrely (P<0.01).The side effects were pioducedin 11/35 old palients and in 32/35 young patients (P<0.01) when the test dose were given iv.If the diagnostic standard for the epidural venous injection of test dose was an increase in HR by 10 beat/min using peak-to-peak criteria or an ex- perence of side effects,the accuracy were 88.5% or 84.25% in the elderly and 94.2% or 95. 7% in the young.When the two criteria were combined,the accuary in older patients and in younger patients would rise to 90.0% and 95.7% respectively,The date indicates that the tradi- tional test dose are not reliable in the geriatric population.