小剂量布比卡因腰膜硬膜联合麻醉2点穿刺在老年患者下腹部及以下手术中的对比观察

Comparison of efficacy of small doses bupivacaine for combined spinal-epidural anesthesia by two-point punctures in elderly patients undergoing lower abdominal and below surgery

目的探讨腰膜硬膜联合麻醉(腰硬联合麻醉)2点穿刺法的操作性和安全性。方法 60例择期行下腹部及以下手术的老年患者随机均分为2组,腰硬联合麻醉单点穿刺A组布比卡因8～12 mg;腰硬联合麻醉2点穿刺B组布比卡因5～6mg。监测并记录麻醉前及麻醉后30 min内血压、心率、氧饱和度的变化,观察麻醉效果及麻醉后不良反应。结果 A组血压较B组显著下降(P<0.05),2组麻醉效果和不良反应无差异(P>0.05)。结论小剂量布比卡因腰硬联合麻醉2点穿刺在老年患者下腹部及以下的手术中,更加安全和有效。

Objective To compare the operability and safety of combined spinal-epidura] anesthesia（CSEA） by two-point punctures in elderly patients undergoing lower abdominal and below surgery. Methods Sixty elderly patients undergoing lower abdominal and below surgery were ran- domly divided into two groups. Group A （ n = 30） received CSEA by single-point punctures bupivacaine 8 - 12 rag, while group B （ n = 30） received CSEA by two-point punctures bupivacaine 5 - 6 rag, The changes of BP, HR, SPO2 were recorded before anesthesia and 30 rain after anesthesia. Effect of anesthesia and adverse reactions of anesthesia during each operation were compared. Results Compared with group B, blood pressure was significantly lower in group A, and there was significant difference of blood pressure between the two groups （P〈0.05）. The anesthesia effect and adverse reaction in the two groups were not significant （P〉0.05）. Conclusion The small doses bupivacaine for combined spinal-epidural anesthesia by two-point punctures in elderly patients undergoing lower abdominal and below surgery is better safe and effective.