小容量高浓度罗哌卡因硬膜外阻滞复合全麻用于老年患者腹部外科手术

Small-capacity High Concentration Ropivacaine Epidural Anesthesia for Abdominal Surgery in Elderly Patients

目的:探讨以小容量高浓度罗哌卡因行硬膜外阻滞麻醉与全麻复合用于老年病患实施腹部外科手术的效果。方法:选择44例逆行腹部外科手术治疗的老年病患,以硬膜外阻滞与全麻方案实施麻醉,随机分两组,Ⅰ组22例为罗哌卡因小容量高浓度,Ⅱ组22例为小容量常规浓度,对比两组病患麻醉效果。结果:两组硬膜外穿刺点比较,差异无统计学意义(P>0.05);关腹时,Ⅰ组中1例(4.55%)患者追加了肌肉松弛药物,Ⅱ组中10例(45.45%),两组比较差异有统计学意义(P<0.05);术后,Ⅰ组呼吸恢复、拔管及清醒时间与Ⅱ组比较,差异均有统计学意义(P<0.05);两组苏醒期间均未发生躁动反应。结论:临床医师为老年病患实施腹部手术时,采用小容量高浓度罗哌卡因进行硬膜外阻滞,同时开展全麻,可有效加快患者术后恢复,保证病患的安全,具有推广价值。

Objective：To explore the effect of small-capacity high concentrations of ropivacaine epidural anesthesia combined with general anesthesia for abdominal surgery in elderly patients.Method：Selected 44 cases of retrograde abdominal surgery in elderly patients,with epidural block anesthesia and general anesthesia scheme,they were randomly divided into two groups,group I 22 cases with small-capacity high concentrations,groupⅡ22 cases of small-capacity conventional concentration,compared anesthetic effect of two groups.Result：Two epidural puncture point,the difference was not significant（P〉0.05）;When the abdomen was closed,groupⅠhad 1 case（4.55%） were added muscle relaxant drugs,groupⅡhad 10 cases（45.45%）,the comparison of two groups was no statistically significant difference（P〈0.05）;After operation,the respiration,extubation and recovery time of groupⅠwere less than groupⅡ（P〈0.05）;The agitated reaction of two groups did not appear in recovery period.Conclusion：Clinicians for the implementation of abdominal surgery in elderly patients,the use of high concentrations of small capacity ropivacaine for epidural anesthesia,while carrying out general anesthesia,which can effectively accelerate postoperative recovery,to ensure patient safety,is worth promoting.