罗哌卡因等比重腰-硬联合麻醉在老年患者下肢骨科手术中的应用

Application of Ropivacaine for combined spinal-epidural anesthesia in lower extremity patients aged over 75

目的评价罗哌卡因等比重腰-硬联合麻醉用于75岁以上老年患者下肢骨科手术的安全性和可行性。方法随机将50例ASAⅡ～Ⅲ级接受下肢手术的老年患者分为硬膜外(CEA)组(n=25),腰-硬联合(CSEA)组(n=25),观察各组感觉阻滞完善时间、麻醉效果、镇痛效果、血流动力学及不良反应。结果 CSEA组比CEA组起效快,肌肉松弛和平面控制好,阻滞完善(P<0.01)。CSEA组比CEA组循环稳定,但差异无统计学意义(P>0.05)。结论等比重罗哌卡因腰-硬联合麻醉用于高龄患者下肢骨科手术具有起效迅速、麻醉效果满意和血流动力学稳定的优点。

Objective To evaluate the efficacy and feasibility of Ropivacaine for combined spinal-epidural anesthesia in lower extremity patients aged over 75.Methods Fifty over seventy-five years old ASA grade Ⅱ-Ⅲ patients were randomly divided into continuous epidural anesthesia（CEA） group and CSEA group,25 cases in each.Onset of sensory block,anesthetic effect,analgesic effect,hemodynamics and adverse effect were observed.Results CSEA produced shorter effect time,got better muscle relaxation,good horizontal control and complete block（P0.01）.CSEA group circulated more stably than the CEA group,but the difference was not significant（P0.05）.Conclusion Ropivacaine has the advantage of being rapid onset of anesthesia and hemodynamic stability in the elderly undergoing bones of lower limb operating.