舒芬太尼复合小剂量布比卡因蛛网膜下腔麻醉在老年股骨头置换患者手术中的应用

The Application of Sufentanil Combined with Low-Dose Bupivacaine for Spinal Anesthesia in Elderly Patients

目的观察舒芬太尼复合小剂量布比卡因蛛网膜下腔注射在老年股骨头置换患者麻醉中的临床效果。方法 60例择期行老年股骨头置换手术的患者随机分为三组,每组20例。Ⅰ组:0.5%布比卡因7.5mg+舒芬太尼6μg;Ⅱ组:0.5%布比卡因7.5mg+舒芬太尼3μg;Ⅲ组:0.5%布比卡因10mg行网膜下腔麻醉。观察感觉阻滞起效时间、运动阻滞程度、血流动力学影响及不良反应发生情况。结果Ⅰ、Ⅱ组给药后血流动力学影响小,运动阻滞恢复时间短于Ⅲ组,恶心、头晕发生率明显低于Ⅲ组(P<0.05);Ⅰ组感觉阻滞起效时间,达T10时间明显短于Ⅱ组和Ⅲ组,T10镇痛维持时间明显长于Ⅱ组和Ⅲ组(P<0.05)。结论舒芬太尼3、6μg复合小剂量布比卡因蛛网膜下腔注射用于老年患者均可产生良好的感觉和运动阻滞,且对血流动力学影响小。

Objective To investigate the effect of spinal anesthesia with differentdoses of sufentanil combined with low-dose bupivacaine in elderly patients.Methods Sixty patients Replacement of the femoral head were randomly divided into three groups with 20 cases each,all patients were received spinal anesthesia.Group Ⅰ ：0.5% bupivacaine 7.5mg＋sufentanil 6 μ g;group Ⅱ：0.5%bupivacaine 7.5μg＋sufentainl 3μg;group Ⅲ：0.5%bupivacaine 10mg. The onset time of sensory and motor block,the upper sensory block level,post- operative analgesia,the degree of motor block,hemodynamies and side effects were recorded.Results In group Iand lithe hemodynamics were more stable,the time of regression motor block were faster block were and nausea and dizziness were lower than that in group Ⅲ （P〈0.05） .In group Ⅰthe onset time of sensory block,reaching to the T10 dermatomes of time were shorter,and post- operative analgesia was longer than in groups Ⅱ,Ⅲ （P〈O.05） .Gone l us i on Sufentanil combined with low-dose bupivacaine for spinal anesthesia in elederly patients can provide adequate sensory and motor block without hemodynamie instability.