不同剂量等比重罗哌卡因对老年患者腰麻阻滞平面的影响

Effect of dosage of spinal anesthesia with isobaric ropivacaine on block in elder patients

目的观察不同剂量0.5%等比重罗哌卡因用于老年患者腰麻对阻滞平面的影响。方法 65岁以上经尿道前列腺电切术患者160例随机分为四组,每组40例。A、B、C、D四组蛛网膜下腔分别注入0.5%等比重罗哌卡因7.5、10、12.5、15mg。用针刺法测定感觉阻滞平面,用改良Bro-mage法评估下肢运动阻滞程度,比较四组患者的感觉和运动阻滞效果。结果最高阻滞平面:D组>C组>B组>A组。D组阻滞平面固定时间显著长于A组(P<0.05)。A、B组感觉阻滞消退时间短于C、D组(P<0.01)。结论 0.5%等比重罗哌卡因腰麻时局麻药剂量越大阻滞平面越高。老年患者经尿道前列腺电切术选择0.5%罗哌卡因10～12.5mg为宜。

Objective To observe the effects of different doses of 0.5 % ropivacaine on block of spinal anesthesia in elder patients. Methods One hundred and sixty aged greater than 65 years old patients undergoing selective transurethral resection of the prostate （TURP） were randomly divided into four groups with 40 cases each. Ropivacaine 7.5 mg（group A）, 10 mg（group B）, 12.5 mg（group C） and 15 rag（group D） were used. The plane of sensation block was measured, the onset time of block and the highest block level were recorded. Results The plane of block was in an order of D C〉B〉A. The level fixing time of group D was longer than that of group A（P〈0.05）. The level regression time of groups of A and B was shorter than that of groups of C and D （P 〈 0. 05）. Conclusion The plane of spinal anesthesia elevates as the dose of 0.5% ropivacaine increases. Isobaric ropivacaine 10 to 12.5 mg is suitable for spinal anesthesia in aged patients undergoing TURP.