老年患者低位硬膜外阻滞局麻药的初量用量分析

Clinical analysis of initiative dose of local anesthetics of low epidural blockade in the aged

目的探讨不同年龄段老年人硬膜外阻滞局麻药初量用量，为临床麻醉提供依据。方法总结400例低位硬膜外阻滞，100例20～50岁患者为对照组即Ⅰ组，300例老年病例，按年龄段分为3组，每组100例，即Ⅱ组60～69岁，Ⅲ组70～79岁，Ⅳ组大于80岁。所有患者均选择腰2～3间隙行硬膜外穿刺、置管。结果Ⅰ、Ⅱ、Ⅲ、Ⅳ4组患者硬膜外阻滞局麻药初量分别为：（16．8±3．3）ml、（13．8±2．8）m1、（11．3±3．0）ml和（8．5±2．3）ml。不同年龄段老年人局麻药初量较对照组及各年龄段之间均有差异。结论低住硬膜外阻滞，Ⅱ、Ⅲ、Ⅳ组老年患者初量分别为对照组的82％、67％和51％。

Objective To evaluate the initiative dose of low epidural blockade in the aged. Method Four hundred patients were assigned to four groups, including 20-50 years old group （group Ⅰ ） ,60～69 years old group（group Ⅱ ）, 70～79years old group（group Ⅲ ） and more than 80 years old group （group Ⅳ）. Result Group Ⅰ ,group Ⅱ ,group Ⅲ and group IV initiative dose were （16. 8±3.3） ml, （13. 8±2.8） ml, （11.3±3.0）ml and（8. 5±2.3） ml, which indicated that group Ⅱ , Ⅲ and IV initiative dose of continuous lumbar epidural anesthesia was significantly decreased compared that of group Ⅰ. Conclusion It needs less initiative dose of local anesthetics of low epidural blockade in the aged.