轻比重丁哌卡因腰麻用于人工股骨头置换术

Surgical repair of the fracture of neck of femur using spinal anesthesia with hypobaric bupivacaine

目的：评价０．２％轻比重丁哌卡因液用于老年人股骨颈骨折修复术腰麻的效应。方法：选择４０例ＡＳＡⅠ～Ⅲ级股骨颈骨折病人，年龄６４～８０岁，在０．２％轻比重丁哌卡因腰麻下行人工头置换术，手术与麻醉体位一致，随机分为两组，观察快速注药组（Ｆ组０．３ｍｌ／ｓ）和慢速注药组（Ｓ组０．０３３ｍｌ／ｓ）对麻醉平面及血流动力学的影响。结果：Ｓ组感觉平面（Ｔ７．５±１．４）明显低于Ｆ组（Ｔ５．５±１．６）；同组双侧感觉平面无明显差别，但潜伏期不同；同组中患侧运动阻滞明显优于健侧运动阻滞；注药后Ｓ组平均动脉压下降明显低于Ｆ组。结论：慢速注射０．２％轻比重丁哌卡因腰麻在老年人人工头置换术中操作简单，麻醉效果可靠。

Objective:To evaluate the effect of 0 2% hypobaric bupivacaine in spinal anesthesia at different injection rate during the surgical repair of the fracture of femur neck Method:Forty elderly patients,scheduled for hip surgery,were randomly allocated to being injeted with 6 ml of 0 2% hypobaric bupivacaine at rate of 1/3 ml s -1 (group FI) 1/30 ml s -1 (group SI) respectively,at the lateral decubitus position,with the operated side up,and the table being kepted horizontal Result:No difference was observed in the sensory level between two sides in each group The motor block was significantly better in the operated side than the other side of both groups As compared with those of group FI,the maximal sensory level was significantly lowered (T7 5±1 4 vs T5 5±1 6,P<0 05),and the mean blood pressure decreased markedly less in group SI Conclusion:Injection of 0 2% hypobaric bupivacaine at solw rate can be applied effectively,safely and simply to the spinal anesthesia for the elderly patient