左布比卡因腰-硬联合麻醉在高龄患者股骨手术的应用

Application of combined spinal-epidural anesthesia with levo-bupivacaine in elderly patients undergoing thighbone surgery

目的观察左布比卡因腰-硬联合麻醉(CSEA)应用于高龄患者股骨手术的效果及安全性。方法 40例高龄患者在腰-硬联合麻醉下行股骨手术。麻醉药物为0.75%左布比卡因9 mg(0.75%左布比卡因1.2 ml加脑脊液0.3 ml稀释)。监测平均动脉压、心率、脉搏氧饱和度、心电图。记录麻醉起效时间、麻醉平面、麻醉效果、不良反应及麻醉后并发症。结果全部患者麻醉效果满意,麻醉前后血流动力学无显著变化(P﹥0.05),起效时间(10±7)min,术中无恶心呕吐,术后无头痛及神经损伤等麻醉并发症。结论左布比卡因腰-硬联合麻醉对呼吸循环系统干扰小、效果确切,可安全应用于高龄患者股骨手术。

Objective To observe the effect and safety of application of combined spinal-epidural anesthesia with levo-bupivacaine in elderly patients undergoing thighbone surgery.Methods 40 elderly patients underwent thighbone surgery with combined spinal-epidural anesthesia.All of the patients were given 9mg of 0.75% levo-bupivacaine（1.2ml of 0.75% levo-bupivacaine was attenuated with 0.3ml of cerebrospinal fluid）.MAP,HR,SpO2 and ECG were monitored.The time till effect of anesthesia,block levels,effect of analgesia,side effect and complications were recorded.Results The effect of analgesia of all patients were satisfactory.The hemodynamics had no obvious variations before and after anesthesia（P0.05）.The time till effect of anesthesia was（10±7） minutes.There was no nausea,vomiting in the operation and no complications after anesthesia such as headache or nerves injury.Conclusions Combined spinal-epidural anesthesia with levo-bupivacaine seldom interferes with respiratory and re-circulating system and it is effective,so it is safe for elderly patients undergoing thighbone surgery.