去氧肾上腺素在硬-腰联合麻醉引起低血压的老年患者中的应用

The application of phenylephrine during anesthesia hypotension in elderly patients with combined epidural-spinal anesthesia

目的观察去氧肾上腺素和麻黄素对椎管内麻醉患者血压、心率的影响。方法随机选取ASA I～Ⅱ65岁以上,欲行下肢或下腹部手术患者60例,随机分为两组,每组30例。椎管内麻醉后血压下降至基础血压30%以上时,即刻给予麻黄素(E组)100μg/kg或者去氧肾上腺素(P组)2μg/kg,必要时重复给药,记录患者基础血压、心率、给药前血压、心率、起效时间、给药后血压、心率及收缩压×心率(RPP)。结果两组患者一般资料的差异无统计学意义,给药后两组血压均上升,E组患者心率和RPP较给药前上升,P组心率和RPP较给药前下降。结论去氧肾上腺素用于治疗老年患者椎管内麻醉引起的血压下降具有起效快、效果确切及不增加心率等优点。

【Objective】 To observe the effect of phenylephrine and ephedrine for blood pressure and heart rate in patients with spinal anesthesia.【Methods】 Sixty ASA I~Ⅱ patients over the age of sixty-five undergoing lower extremity or lower abdominal surgery were randomly assigned to two groups of E（ephedrine） and P（phenylephrine）.After spinal anesthesia blood pressure dropped by 30%,100 μg/kg of ephedrine（E group） or 2 μg/kg of phenylephrine（P group） was instantly given,repeating the dose if necessary.The basic blood pressure and heart rate,blood pressure and heart rate before administration,onset time,blood pressure and heart rate after administration,systolic blood pressure × heart rate（RPP） were recorded.【Results】 There was no significant difference of general information between two groups.Blood pressure of two groups after administration significantly increased.Heart rate and RPP increased in E group and decreased in P group compared with pre-administration.【Conclusion】 Phenylephrine for the treatment of anesthesia hypotension in elderly patients with spinal anesthesia has characters of quick onset,satisfactory efficacy and steady heart rate.