不同浓度葡萄糖复合罗哌卡因用于老年患者腰麻的效果

Comparison of spinal anaesthesia with ropivacaine and different concentrations of glucose in the elderly patients

目的观察0.67%的罗哌卡因复合不同浓度葡萄糖用于老年患者腰麻的效果。方法 ASA分级Ⅰ～Ⅱ级行择期单侧大隐静脉曲张高位结扎分段剥脱术的老年患者80例,65～80岁,随机分为四组,每组20例:5%1,0%,25%,50%葡萄糖组。所有患者患侧卧位,选择L3～4腰椎间隙进行穿刺。观察4组感觉运动神经阻滞情况,血流动力学变化麻醉效果以及不良反应。术中监测生命体征,术后随访观察患者是否出现麻醉并发症。结果 50%葡萄糖组感觉运动阻滞起效时间明显比其他3组时间短(P<0.05),痛觉阻滞,运动阻滞持续时间明显比其他3组长(P<0.05),但是25%葡萄糖组腰麻阻滞平面较50%葡萄糖组更加平缓稳定。4组不良反应发生率都很低,差异不显著(P>0.05),4组血流动力学变化差异不显著(P>0.05),4组中均无麻醉失败患者。结论 0.67%罗哌卡因复合25%葡萄糖可以更加安全地用于老年患者蛛网膜下腔阻滞。

Objective To observe the effect of 0.67% ropivacaine combined different concentration of glucose on the aged patients underwent lumbar anesthesia.Methods Eighty patients undergoing unilateral high ligation segmentation stripping of great saphenous varicose vein surgical procedures,aged from 65~80 years old,were randomly allocated to 5%,10%,25% and 50% glucose groups.All patients were affected lateral decubitus position.Lumbar space of L3~4 was selected to puncture.The sensorimotor nerve block,hemodynamics change and adverse reaction were observed.Vital signs of the patients during operation were monitored.The patients were followed up after operation to record complications related anesthesia.Results Onset of sensorimotor block in 50% glucose group was shorter than that of the other three groups（P0.05）,algesia and motor block duration in 50% glucose group was longer than that of the other three groups（P0.05）.But lumbar anesthesia block plane of 25% glucose group was more stable than that of 50% glucose group.There were very low incidences of adverse reaction of the four groups without significant difference（P0.05）.Four groups had no significant difference in hemodynamics changes（P0.05） and no anesthesia failure.Conclusions 0.67% ropivacaine combined 25% glucose could safely used in the aged patients with subarachnoid block.