麻醉前输液对老年患者腰-硬联合麻醉血压的影响

Before anesthesia the effect of Infusion on blood pressure of elder patients with combined spinal-epidural anesthesia

目的观察麻醉前输入胶体液对老年患者腰-硬联合麻醉血压的影响。方法选取60岁以上行腰-硬联合麻醉行下肢手术的老年患者60例,随机分为两组,每组30例,均经L2～3或L3～4间隙行腰-硬联合麻醉,A组麻醉前30 min输入万汶8～10 ml/kg;B组麻醉前输入复方林格氏液8～10 ml/kg,分别记录麻醉前、麻醉后5 min的血压。结果两组患者的SBP、DBP、MAP麻醉后5 min均有所下降,但B组下降幅度明显高于A组,差异有统计学意义(P<0.05);A组患者血压降低的发生率和波动幅度均明显低于B组。结论老年人实施腰-硬联合麻醉,在术前输入适量胶体溶液,可以降低低血压的发生率及血压下降幅度,使麻醉更加平稳。

Objective To observe the effect of Infusion on blood pressure of elder patients with com- bined spinal-epidural anesthesia before anesthesia. Methods Patients over the age of 60 with combined spinal- epidural anesthesia undergoing elective lower extremity operation were randomly and evenly divided into two groups. Two groups underwent the CSEA by L2 - 3 or L3 - 4 gap. Thirty minutes before anesthesia, Group A and Group B were administered with Voluven（8-10 ml/kg）and Parkland＇s formula（8-10 ml/kg） respectively. Record blood pressure respectively 5 minutes before and after anesthesia. Results Two groups＇ patients＇ SBP, DBP and MAP 5 minutes after anesthesia have declined, but the decline of Group B was significantly higher than that in Group A, there is a significant difference （P 〈 0. 05 ） ; The BP reduction＇ s incidence rate and fluc- tuation margin of Group A are significantly lower than the Group B. Conclusion The elder patients with com- bined spinal-epidural anesthesia, preoperatively input appropriate amount of colloidal solution, can reduce the incidence of low blood pressure and the decrease margin of blood pressure, and make anesthesia more stable.