腰硬联合麻醉用于高龄患者TURP布比卡因最小有效剂量探讨

Study of Combined Spinal Epidural Anesthesia with Bupivacaine in the Elderly Undergoing TURP Surgery

目的：探讨布比卡因腰麻用于高龄患者TURP的最小有效剂量。方法：60例高龄患者在腰硬联合麻醉下行TURP。按所用布比卡因剂量不同随机分为三组,每组20例。Ⅰ组用3mg,Ⅱ组4.5mg,Ⅲ组6mg。观察感觉阻滞平面、运动阻滞程度、麻醉效应、不良反应及硬膜外追加2%利多卡因情况。结果：Ⅰ组麻醉效果较Ⅱ组、Ⅲ组差（p时硬膜外2%利多卡因用量三组间比较差异有统计学意义（p0. 05）。 结论：0．375％等比重布比卡因4．5mg可作为高龄患者TURP手术腰硬联合麻醉给药的最小有效剂量。

ObjectiveTo study the minimal effective dose and safty of Combined spinal epidural anesthesia with Bupivacaine in the elderly undergoing TURP surgery. Methods sixty patient scheduled for TURP were divided into three groups with 20 cases in each group. Bupivacaine 3mg was used in group Ⅰ , Bupivacaine 4.5mg in group Ⅱ , and Bupivacaine 10mg in groupⅢ. The anesthetic effect on sensory and motor blockade, incidence of hypotension and bradycardia, quality of intraoperative analgesia and occurrence of neurological complications within 24 hours postoperatively, and the effectivness of additional epidural lidocain were compared. Result The intensity of motor blockade evaluated with bromage scale in group I was lower than that in group l1 and group HI. No obvious neurological complications were found in three group. The rate of hypotension in group [11 was more than other two group. Conclusion 0. 5% bupivacaine 4.5mg is the minimal and reliable effective dose to be used in the elderly undergoing TURP surgery with lumbar anesthesia, and is highly recommended.