多巴胺维持高龄硬膜外阻滞期间血液循环稳定的观察

目的 观察静脉多巴胺微量泵维持，对高龄硬膜外阻滞期间血液循环稳定的影响。方法 96例高龄患者，ASA Ⅱ～Ⅲ级，选择硬膜外阻滞麻醉，行L2～3穿刺置管，麻醉平面控制在T10以下，随机分成两组，实验组（多巴胺组）和对照组，实验组在麻醉开始后以6μg／（kg·min）的速度静脉泵入多巴胺维持循环稳定，对照组根据血压下降程度，静注麻黄素或多巴胺。记录麻醉后多时点的HR、MAP、CVP、SPO2、ECG的变化及麻黄素使用情况。结果 实验组各观察项目麻醉后各时点与麻醉前比较，无显著性差异（P〉0．05），对照组MAP、CVP麻醉后10、15、20、30、60和75min时点与麻醉前比较，有显著性差异（P〈0．05），HR略有下降，20min时点与麻醉前比较有显著性差异（P〈0．05），出现9例心律失常，20例使用麻黄索。结论 静脉多巴胺微量泵维持，能稳定高龄硬膜外阻滞期间循环，减少麻醉意外和并发症的发生。

Objective To study the effects of epidural blockade on senility patients by maintaining dopamine through micropump infusion intravenously. Methods 96 senility undergoing epidural block were randomly divided into two groups： experimental group （dopamine group） and control group , L2-3 were selected to puncture . For experimental group, dopamine intravenously administered 6μg/（ kg· min ） to maintain circulation stability after anesthesia, while in control group blood pressure decreased evidently and ephedrine or dopamine was used. Variations of HR MAP CVP SPO2 and ECG were recorded at various time. Results There was no significant differences between after and before anesthesia in experimental group （ P 〉 0.05 ）. In control group , compared with the value before anesthesia , MAP and CVP at time point of 10 15 20 30 60 and 75 minutes after anesthesia had significant difference （ P 〈 0.05）, compared with those after during operation （ P 〈 0.05 ）. HR at the time points of 20 minutes after anesthesia decreased slightly （ p 〈 0.05 ）. 9 patients arrhythmia attacked, 20 patients ephedrine administered. Conclusion Dopamine intravenous maintenance with micro pump could maintain circulation stability during epidural block and decrease unexpected incidents and complications in senility.