低浓度罗哌卡因对老年股骨头置换患者血流动力学的影响

Influence of low concentrations of ropivacaine on hemodynamics of elderly patients reciving femoral head replacement

目的探讨低浓度罗哌卡因腰硬麻醉对老年股骨头置换术中血流动力学的影响。方法选取2009年在本院行股骨头置换手术的老年患者60例,将其分为实验组和对照组各30例,实验组腰麻使用低浓度0.2%罗哌卡因,对照组使用0.5%重比重布比卡因。观察两组患者在麻醉后不同时段的收缩压(SBP)、舒张压(DBP)、心率(HR)变化,进行统计分析。结果实验组在麻醉后15 min SBP、DBP降低较对照组明显(P<0.05);HR降低较对照组明显(P<0.05);实验组在麻醉结束时DBP升高较对照组明显(P<0.05)。结论低浓度轻比重罗哌卡因在老年股骨头置换手术中具有循环系统波动小、麻醉平稳的特点,在满足手术麻醉的前提下可有效预防因循环波动引发心脑血管意外及相关并发症的发生。

Objective To investigate the influence of low concentrations of ropivacaine lumbar anesthsia on the hemo dynamics of elderly patients receiving femoral head replacement.Methods Sixty elderly patients who received femoral head replacement surgery in our hospital in 2009 were divided into the experimental group and the control group,with 30 patients in each group.The experimental group received a low concentration of 0.2% ropivacaine for lumbar anes thesia and the control group received 0.5% hyperbaric bupivacaine.The changes of systolic blood pressure（SBP）,dias tolic blood pressure（DBP） and heart rate（HR） at different times of the two groups after the anesthesia were analyzed statistically.Results Fifteen minutes after the anesthesia,the experimental group had more significantly decreased SBP and DBP than the control group（P 0.05） and more significantly decreased HR than the control group（P0.05）;At the end of the anesthesia,the experimental group had more significantly increased DBP than the control group（P 0.05）.Conclusion In the femoral head replacement surgery for elderly patients,low concentrations of hypobaric ropiva caine has the features like small circulatory system fluctuation and stable anesthesia,which can effectively prevent the occurrence of cerebrovascular accidents and related complications caused by circulatory fluctuations on the premise of meeting the surgical anesthesia requirements.