老年患者硬膜外阻滞节段的影响因素分析

The Effect of the dose of local anesthetics and other influential factors on the spread of epidural block in elders

目的分析65岁以上老年患者在硬膜外阻滞中,用药量及年龄,性别,穿刺部位等因素对硬膜外阻滞节段的影响。方法通过3 000例65岁以上老年患者的回顾性调查,采用多元回归的分析方法,得出多元回归方程。结果65岁以上老年患者硬膜外阻滞节段多元回归方程为:Y(阻滞节段数)=3.719 0+0.080 4×X1(年龄)-0.823 0×X2(穿刺部位)-0.014 0×X3(身高)+0.145 7×X40.85(初量),各影响因素中,对于阻滞节段的影响的程度依次为:年龄>用药量>身高>穿刺部位。校正常数可能还包含其他本研究中未考虑在内的影响因素。结论老年患者硬膜外用药量和阻滞节段数呈现指数相关变化,各个影响因素在其中作用程度各异,推导的数学模型对临床工作有一定指导意义。

Objective To evaluate the effect of the influential factors including the dose of local anesthetics, gender and puncture site on the spread of epidural block. Methods Three thousand elders, above 65 years old, were studied retrospectively. Multiple regression was used. Results The multiple regression equation of the spread of epidural block for elders above 65 years old is. Y（ dermatome levels blocked） = 3. 719 0 ＋0.080 4 · X1 （age） - 0. 823 0 · X2 （puncture site） - 0. 014 0 · X3 （height） ＋ 0. 145 7 · X4^0.85 （initial dose）. The order of the extent of the factors＇ effect was be age 〉 dose 〉 height 〉 puncture site. The rectificatory parameters may include other influential factors that were not counted in this study. Conclusion The relation between anesthetic dose for epidural block and spread of block is represented as an exponential correlation. The effect of each influential factor had different extent. The equation got from this study can provide some guidance in clinical practice.