不同浓度重比重罗哌卡因行腰麻用于老年前列腺电切术的研究

The Clinical Research of Different Hyperbaric Ropivacaine Concentrations Used in Lumbar Anesthesia for Elderly Patients undergoing Transurethral Prostatic Resection

目的：观察不同浓度重比重罗哌卡因腰麻用于老年患者前列腺等离子电切术的麻醉效果。方法择期行前列腺等离子电切术的老年患者58例，ASAⅠ-Ⅱ级，按照数字随机表法随机分为A、B两组，每组29例。L3-L4蛛网膜下腔穿刺成功后，两组分别以0.1-0.3 mL/s的速度注入0.5%和0.75%的重比重罗哌卡因（用10%葡萄糖稀释）至蛛网膜下腔，剂量均为12.5 mg，对两组患者进行感觉和运动神经阻滞情况进行监测，观察其麻醉效果以及不良反应。结果与A组相比，B组患者感觉阻滞起效时间明显缩短（P＜0.05），而运动阻滞起效时间差异无统计学意义；与A组相比，B组患者感觉阻滞持续时间明显延长（P＜0.05），而运动阻滞持续时间差异无统计学意义（P〉0.05）；与A组相比较，B组优良率明显增高；两组患者不良反应无明显差别（P〉0.05）。结论0.75%重比重罗哌卡因腰麻用于老年患者前列腺电切术麻醉效果好，镇痛时间长，且无明显不良反应。

Objective To assess the anesthetic effect of different concentrations of hyperbaric ropivacaine used in lumbar anesthesia for elderly transurethral prostatic resection. Methods We randomly divided 58 elderly patients who un-derwent transurethral prostatic resection with ASA （American Surgical Association） physical status level Ⅰ-Ⅱ into 2 groups as group A and B, using numeric random table method. Each group includes 29 cases. After being punctured between L3-L4, patients were injected with 0.5%（group A） and 0.75%（group B） hyperbaric ropivacaine （diluted with 10%glucose） to the subarachnoid space in a speed of 0.1-0.3 mL/s and the overall dose was 12.5 mg in each case. Then the extents of sen-sory and motor block were compared between two groups, and their anesthesia effect and adverse reactions were also record-ed. Results Compared with group A, onset time of sensory block in group B was significantly shorter （P〈0.05）, while onset time for motor block was of no significant difference;By contrast to group A, acting time of sensory block in group B pro-longed significantly （P〈0.05） while acting time of motor block was of no statistically significant difference（P＆gt;0.05）;By con-trast to group A, the anesthesia effect of group B was more effective while the adverse reactions of the two groups was of no significant difference （P〉0.05）. Conclusion 0.75%hyperbaric ropivacaine in lumbar anesthesia for elderly patients un-dergoing transurethral prostatic resection could provide a better anesthesia and analgesia effect than 0.5%hyperbaric ropiva-caine without more significant adverse reactions.